Stable igg4 antibodies

ABSTRACT

The present invention relates to stabilized IgG4 antibodies, to methods of producing such antibodies and to uses of such antibodies as a medicament. In a main aspect, the invention relates to a stabilized IgG4 antibody, comprising a heavy chain and a light chain, wherein said heavy chain comprises a human IgG4 constant region having a substitution of the Arg residue at position (409), the Phe residue at position (405) or the Lys residue at position (370).

All patents, patent applications and other publications cited herein arehereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to novel stabilized IgG4 antibodies, tomethods of producing such antibodies and to uses of such antibodies as amedicament.

BACKGROUND OF THE INVENTION

Antibodies are being used as therapeutic agents for a number of diseasesand disorders, including cancer and autoimmune diseases. Antibodies areimmunoglobulins that recognize specific antigens and mediate theireffects via several mechanisms, including inhibition of ligand-receptorinteractions, inhibition of receptor activation, mediation of receptorinternalization and activation of effector functions, such ascomplement-dependent cytotoxicity (CDC) and antibody-dependent cellularcytotoxicity (ADCC). There are five classes of immunoglobulins: IgG,IgA, IgM, IgD and IgE. The IgG class is further divided into subclassesIgG1, IgG2, IgG3 and IgG4.

Human IgG4 molecules are heterogeneous and exist in various molecularforms, which differ by the absence or presence of inter-heavy chaindisulphide bonds located in the hinge region. Thus, IgG4 molecules existin forms in which either both or none of the inter-heavy chaindisulphide bonds have been formed, a process which is in equilibrium(Schuurman et al. (2001) Mol Immunol 38:1; Bloom et al (1997) ProteinSci 6:407.). The form lacking inter-heavy chain disulphide bondsconsists of one heavy chain and one light chain, and is termed“half-molecule” or “Fab arm” herein. The heterogeneity of IgG4s isbelieved to be related to the core sequence of the IgG4 hinge regionwhich, instead of Cys-Pro-Pro-Cys, as in IgG1 and IgG2, consists ofCys-Pro-Ser-Cys, which is believed to be a more flexible structure. Datathat support the role of the core hinge sequence in this heterogeneityof IgG4 have been reported by Angal et al. (1993) Mol Immunol 30:105. Inthis study, it was shown that by replacement of a Ser residue in thehinge region to a Pro residue, thus changing the core hinge sequence toCys-Pro-Pro-Cys (which is identical to that of IgG1 and IgG2), thepresence of IgG4 half molecules was abolished.

It has been known for several years that IgG4 antibodies, unlike otherIgG subclasses, behave as monovalent molecules in interactions withantigen. It was found that serum-derived human IgG4 cannot precipitatepurified antigen, because it cannot crosslink. While such serum-derivedIgG4 is functionally monovalent (Aalberse et al. (1983) J Immunol130:722; van der Zee et al. (1986) J Immunol 137:3566), recombinantlyproduced, isolated IgG4, in contrast, is behaving bivalently ininteractions with antigens (Schuurman et al (1999) Immunology 97:693).Furthermore,IgG4 antibodies with bispecific reactivity were shown toexist in sera from allergic patients expressing large amounts of IgG4antibodies against two different antigens (Schuurman et al (1999)Immunology 97:693; Aalberse and Schuurman (2002) Immunology 105:9;Aalberse et al (1999) Int Arch Allergy Immunol 118:187). On basis ofthese observations, it was hypothesized that IgG4 antibodies canexchange ‘half-molecules’, an activity termed Fab arm exchange herein.

Several different allotypes of human IgG4 have been found to exist. Oneof these allotypes contains a Leu residue at position 309 and a Lysresidue at position 409, which in other allotypes is an Arg residue(Brusco et al (1998) Eur J Immunogen 25:349). In WO2006/033386, it hasbeen shown that an IgG4 antibody could be rendered more stable at low pHby introduction of an Arg to Lys mutation at position 409 into anantibody context that also contained mutations of the hinge region,including the above mentioned mutation of the core sequence toCys-Pro-Pro-Cys.

IgG4 antibodies have a poor ability to induce complement and cellactivation because of a low affinity for C1q and Fc-receptors. Thismakes IgG4 the preferred isotype for development of immunotherapies inwhich recruitment of host effector functions is not desired.

However, for any therapeutic use of an antibody, a high degree of invivo stability of the antibody is desired.

SUMMARY OF THE INVENTION

It is demonstrated in the present patent application that administrationof two recombinant monoclonal IgG4 antibodies having differentantigen-binding specificities to a mouse leads to in vivo formation ofbispecific antibodies. The phenomenon can be reproduced in vitro byincubating IgG4 antibodies with cells or under reducing conditions. Itwas shown that IgG4 antibodies having different antigen-bindingspecificities engage in Fab arm exchange which is stochastic and inwhich all IgG4 molecules seem to participate. Thus IgG4 antibodies formbispecific antibodies without concomitant formation of aggregates.

IgG4 antibodies therefore have unusual properties which are undesirablein vivo: IgG4 antibodies are unstable, dynamic, molecules which engagein Fab arm exchange. An administered therapeutic IgG4 antibody mayexchange with endogenous IgG4 antibodies with undesired specificities.The random nature of this process introduces unpredictability which ishighly undesirable for human immunotherapy.

The present invention relates to stabilized forms of IgG4 antibodiesthat have a reduced ability to undergo Fab-arm exchange. It hassurprisingly been found that substitution of the Arg residue at position409 or the Phe residue at position 405 in human IgG4 can prevent Fab armexchange, and thus stabilize IgG4, even in the absence of a mutation ofthe core hinge region sequence to Cys-Pro-Pro-Cys. This was unexpected,because it was believed that elimination of the flexibility of the hingeregion via a change of the core hinge sequence to Cys-Pro-Pro-Cys was arequirement for prevention of half-molecule exchange.

Accordingly, in a main aspect, the invention relates to a stabilizedIgG4 antibody for use as a medicament, comprising a heavy chain and alight chain, wherein said heavy chain comprises a human IgG4 constantregion having a substitution of the Arg residue at position 409, the Pheresidue at position 405 or the Lys residue at position 370, wherein saidantibody optionally comprises one or more further substitutions,deletions and/or insertions, with the proviso that if the antibody has aresidue selected from the group consisting of: Lys, Ala, Thr, Met andLeu at the position corresponding to 409, then the antibody does notcomprise a Cys-Pro-Pro-Cys sequence in the hinge region.

The substitutions at positions 409, 405 and 370 can be presentindividually or in any combination.

In a main embodiment, the invention relates to an isolated stabilizedIgG4 antibody for use as a medicament, comprising a heavy chain and alight chain, wherein said heavy chain comprises a human IgG4 constantregion having a residue selected from the group consisting of: Lys, Ala,Thr, Met and Leu at the position corresponding to 409 and/or a residueselected from the group consisting of: Ala, Val, Gly, Ile and Leu at theposition corresponding to 405, and wherein said antibody optionallycomprises one or more further substitutions, deletions and/orinsertions, but does not comprise a Cys-Pro-Pro-Cys sequence in thehinge region.

In several embodiments, the antibodies used in the invention have theadvantage that they contain a minimal number of sequence changes in theconstant region as compared to naturally occurring IgG4. This reducesthe risk of immunogenicity when the antibody is used for human therapy.

In one particular embodiment, the constant region of the stabilized IgG4antibody of the invention is even identical to that of the abovementioned Lys409 allotype described by Brusco et al. (1998) Eur JImmunogen 25:349. Thus, in that particular embodiment, the constantregion of the antibody is identical to antibodies found naturally inhumans.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1. SDS-Page analysis of purified recombinant IgG1 and IgG4. Afterpurification, the Betv1 and Feld1, IgG1 and IgG4 antibodies wereanalyzed on non-reducing SDS-PAGE.

FIG. 2. Bispecific IgG levels in nu/nu Balb/c mice at different timepoints. The amount of bispecific IgG as determined in the heterologouscross-linking assay was plotted versus the amount of Bet v 1 specificIgG as determined in the Bet v 1 binding test. Data from IgG1 and IgG4containing plasma samples are represented by open symbols and closedsymbols, respectively. The dashed line represents the calculated amountof bispecific IgG, if the exchange of IgG half molecules is random andcomplete.

FIG. 3. Bispecific human IgG4 molecules are generated in vivo. (A)Groups (n=5) of SCID mice were injected with chimeric antibody mixtures:100 μg IgG1-Betv1/100 μg IgG1-Feld1 (squares), 100 μg IgG4-Betv1/100 μgIgG4-Feld1 (circles), or 3) 100 μg IgG4-Betv1/100 μg IgG4-Feld1 +2,000μg irrelevant recombinant IgG4 (IgG4-EGFR; triangles). Generation ofbispecific antibodies was followed in time by assessing the bispecificactivity to Bet v 1 and Fel d 1 in plasma. The fraction of bispecificIgG relative to the total IgG-Bet v 1 concentration was expressed aspercentage. The arrow with asterisk indicates the bispecific reactivitylevel expected in mice receiving IgG4-Betv1/IgG4-Feld1 in the presenceof excess irrelevant IgG4 (4%), the arrow without asterisk that in micereceiving IgG4-Betv1/IgG4-Feld1 mixture (50%). Error bars represent SEM.(B) Monospecific cross-linking activity was tested by assessingcross-linking of radiolabeled Fel d 1 to Fel d 1-coupled Sepharose inmouse plasma. Monospecific reactivity was expressed as the ratio betweenthe amount of radiolabeled Fel d 1 bound by cross-linking and totalIgG-Feld1 in order to correct for the clearance of IgG. Error barsrepresent SEM.

FIG. 4. SEC analysis of bispecific activity in murine plasma.

Plasma (10 μl) drawn at t=24 h from a mouse dosed with an IgG4 mix wasfractionated on a Superdex200 column. The mouse was dosed with a mixcontaining 300 μg of Bet v 1 binding IgG4 and 300 μg of Fel d 1 bindingIgG4. In the fractions the concentration of Fel d 1 specific IgG (▪) wasmeasured in the antigen binding test and the concentration of bispecificIgG Bet v 1-Fel d 1 () was determined in the Bet v 1-Fel d 1cross-linking assay. Calibration of this column using IVIg has revealedthat monomeric, dimeric and aggregated IgG elute at 12.9, 11.0 and 8.4ml, respectively (data not shown).

FIG. 5. Fab arm exchange of IgG in whole blood components

Exchange of IgG4 and IgG1 was evaluated by incubating chimeric IgGmixtures in whole blood, blood cells, plasma and serum for 24 h at 37°C., after which bispecific activity in the heterologous cross-linkingassay (Fel d 1-Bet v 1) was measured. Blood was obtained from twodonors: donor A (black bars) and donor B (grey bars). Bispecificactivities were determined in mixtures supplemented with chimeric IgG4(panel A), chimeric IgG1 (panel B) or without the addition of IgG (panelC). All presented data were measured after 24 h of incubation at 37° C.

FIG. 6. Fab arm exchange of IgG by human blood cells

Fab arm exchange of IgG4 (black bars) and IgG1 (grey bars) was evaluatedby incubating chimeric IgG mixtures with mononuclear cells (MNC),thrombocytes (Thr) and erythrocytes (Ery) for 48 h at 37° C., afterwhich bispecific activity in the heterologous cross-linking assay (Fel d1-Bet v 1) was measured. As a control the antibody mixtures were alsoincubated in serum free culture medium (SFC). Bispecificity is expressedas percentage ¹²⁵I-Bet v 1 bound relative to amount added.

FIG. 7. Fab arm exchange of IgG4 by HEK and murine cell lines

Fab arm exchange of IgG4 half molecules was evaluated by incubating achimeric IgG4 mixture with HEK cells, murine B cells (J558) or hybridomacells at 37° C. Bispecific activity in the heterologous cross-linkingassay (Fel d 1-Bet v 1) was measured in samples of 1 μl drawn at t=0 h(gray bars) and at t=24 h (black bars). Bispecificity is expressed aspercentage ¹²⁵I-Bet v 1 bound relative to amount added.

FIG. 8. Erythrocyte-mediated Fab arm exchange of IgG4

Incubation of IgG4-Betv1/IgG4-Feld1 mixtures with freshly purifiederythrocytes (ery, closed symbols) resulted in the generation ofbispecific antibodies, whereas no bispecificity was observed for themixture of the IgG1 isotypes. As control, antibody mixtures wereincubated in PBS without erythrocytes (open symbols). The arrowindicates the maximal expected percentage of bispecific IgG (50%). Errorbars represent range of duplicate measurements.

FIG. 9. Absence of Fab arm exchange of IgG4 in PBS

Fab arm exchange in PBS of IgG1 (white bars), IgG4 (grey bars) and IgG4in the presence of excess irrelevant IgG4 (black bars) was evaluated bymeasuring bispecific activity (panel A), bivalency and antigen binding.The exchange of IgG Fab arms in panel A was calculated from theconcentration of bispecific IgG (as determined in the heterologouscross-linking assay) and the maximal expected concentration ofbispecific IgG if the exchange of IgG half molecules is random andcomplete. The Fab arm exchange was expressed as percentage of themaximal exchange, being 100%. In panel B Fel d 1 bivalency in time isdepicted, which was measured in the homologous cross-linking assay. Theconcentration of bivalent IgG was normalized by setting theconcentration of bivalent IgG at t=0 at 100%.

FIG. 10. Fab arm exchange of IgG4 by erythrocyte lysate

Fab arm exchange of IgG4 was evaluated by incubating a chimeric IgG4mixture in lysate from erythrocytes at 37° C. IgG4 was incubated withincreasing dilutions of lysate. Bispecific activity in the heterologouscross-linking assay (Bet v 1-Fel d 1) was measured in samples drawn atindicated time points. Bispecificity is expressed as percentage ¹²⁵I-Betv 1 bound relative to amount added.

FIG. 11. SEC analysis of bispecific activity induced by erythrocytelysate

IgG4 was incubated with freshly prepared erythrocyte lysate at 37° C.for 24 h and subsequently fractionated on a Superdex200 column, whichwas run at 0.5 ml/min on an AKTA HPLC unit (Amersham Biosciences,Uppsala, Sweden). In the fractions the concentration of Bet v 1 specificIgG (▪) was measured in the antigen binding test and the concentrationof bispecific IgG Fel d 1-Bet v 1 () was determined in the Bet v 1-Feld 1 cross-linking assay. Calibration of this column has revealed thatmonomeric, dimeric and aggregated IgG elute at 12.1, 10.3 and 8.3 ml,respectively (data not shown).

FIG. 12. GSH mediated Fab arm exchange of IgG4

GSH mediated exchange of IgG4 Fab arms was evaluated by incubating IgG4in the presence of increasing concentrations of GSH in PBS/Azide. Atindicated time points samples were drawn in which antigen binding andbispecific activity was measured. The exchange of IgG4 Fab arms wascalculated from the measured concentration of bispecific IgG (asdetermined in the heterologous cross-linking assay) and the maximalexpected concentration of bispecific IgG4 if the exchange of IgG4 Fabarms is random and complete. The exchange was expressed as percentage ofthe maximal exchange, set at 100%.

FIG. 13. SEC of GSH mediated Fab arm exchange of IgG4 half molecules

IgG4 was incubated with GSH (0.5 mM) and subsequently fractionated on aSuperdex200 column, which was run at 0.5 ml/min on an AKTA HPLC unit(Amersham Biosciences, Uppsala, Sweden). In the fractions theconcentration of Bet v 1 specific IgG (▪) was measured in the antigenbinding test and the concentration of bispecific IgG Fel d 1-Bet v 1 ()was determined in the Bet v 1-Fel d 1 cross-linking assay. Calibrationof this column has revealed that monomeric, dimeric and aggregated IgGelute at 12.1, 10.3 and 8.3 ml, respectively (data not shown).

FIG. 14. Temperature dependence of GSH mediated Fab arm exchange ofIgG4. IgG4-Betv1 and IgG4-Feld1 mixtures were incubated in PBS with GSHat indicated temperatures. At t=0 h (gray bars) and t=24 h (black bars)concentrations of bispecific IgG4 were assessed. From these data thefraction of bispecific IgG relative to the IgG4 Betv1 concentration wascalculated and expressed as percentage. Error bars represent range ofduplicate measurements.

FIG. 15. IgG4 Fab arm exchange mediated by a panel of reducing agents.IgG4-Betv1 and IgG4-Feld1 in PBS were incubated in the presence ofdifferent agents (all reducing, except GSSG) for 24 h at 37° C. Theconcentration of Bet v 1 specific IgG was measured in the Bet v 1binding assay and the concentration of bispecific IgG was measured inthe heterologous cross-linking assay (Fel d 1-Bet v 1). The percentageof bispecific IgG relative to the IgG-Betv1 concentration wascalculated. Standard error bars represent SEM calculated from threemeasurements.

FIG. 16. Fab arm exchange of fully human IgG4 antibodies using GSH.

(A) IgG4-CD20/IgG4-EGFr or IgG1-CD20/IgG1-EGFr mixtures were incubatedat 37° C. with or without 0.5 mM GSH. Samples were taken at indicatedtime points. The formation of bispecific antibodies was measured in asandwich ELISA. Y-axis indicates the optical density at 405 nm as ameasurement of the formation of bispecific CD20/EGFR antibodies.

(B) GSH-dose dependent Fab arm exchange of IgG4. A mixture of IgG4-CD20and IgG4-EGFr was incubated for 24 h at 37° C. with concentrations ofGSH as indicated. The formation of bispecific antibodies was measured ina sandwich ELISA. The optical density at 405 nm is plotted on the Y-axisas a measurement of the formation of bispecific CD20/EGFR antibodies.

(C) GSH-mediated exchange of IgG4 Fab arms is influenced by thecomponents used in the reaction, and occurs in culture medium (Freestyle293) at lower GSH concentrations.

(D) GSH-mediated Fab arm exchange of IgG4 is higher at 0.5 mM GSH thanat 5 mM GSH.

(E/F) Detection of Fab arm exchange between IgG4-EGFR and IgG4-CD20 byESI-TOF mass spectrometry. An IgG4 mixture was incubated for 24 hours inthe absence (E) or presence (F) of 0.5 mM GSH, after which theantibodies were deglycosylated with PNGase F and the molecular weightsof the resulting antibodies were determined by ESI-TOF massspectrometry. Shown are the deconvoluted ESI-TOF spectra. Data arerepresentative of 2 experiments.

FIG. 17. Rhesus monkey IVIg participates in Fab arm exchange ofrecombinant human IgG4 antibodies. Mixtures of two recombinant humanIgG4 antibodies (IgG4-CD20 and IgG4-EGFr) were incubated with GSH for 24h at 37° C., in the presence or absence of rhesus monkey or human IVIg.The formation of bispecific antibodies through Fab arm exchange wasmeasured in a sandwich ELISA.

FIG. 18. GSH mediated Fab arm exchange of IgG1 mutants

The effect of GSH concentration on the Fab arm exchange from differentIgG1 mutants was tested using 0, 0.1, 1 and 10 mM GSH. Fab arm exchangewas tested using the following mixtures:

IgG4 anti-feld1 wt with IgG4 anti-betv1 wt (indicated as IgG4 wt in thefigure)

IgG1 anti-feld1 wt with IgG4 anti-betv1 wt (indicated as IgG1 wt)

IgG1 anti-feld1 CPSC with IgG1 anti-betv1 CPSC (indicates as IgG1-CPSC)

IgG1 anti-feld1 CH3(IgG4) with IgG1 atni-betv1 CH3(IgG4) (indicated asIgG1-CH3 (IgG4))

IgG1 anti-feld1 CPSC/CH3(IgG4) with anti-betv1 IgG1 CPSC/CH3(IgG4))(indicated as IgG1-CPSC-CH3 (IgG4))

FIG. 19. Schematic representation of constructs for IgG1 and IgG4containing mutations in the core hinge and/or CH3 domain.

FIG. 20. Fab arm exchange of IgG1 and IgG4 hinge region or CH3 domainmutants.

FIG. 21. Binding of hingeless IgG4 antibody 2F8-HG and CH3 mutants2F8-HG-F405L, 2F8-HG-F405A, 2F8-HG-R409A and 2F8-HG-R409K to EGFr.Binding was tested in an EGFR ELISA in the presence and absence ofpolyclonal human IgG (IVIG).

FIG. 22. Sequence alignment of anti-EGFr antibody 2F8 in a IgG1, IgG4and (partial) IgG3 backbone. Amino acid numbering according to Kabat andaccording to the EU-index are depicted (both described in Kabat et al.,Sequences of Proteins of Immunological Interest, 5th Ed. Public HealthService, National Institutes of Health, Bethesda, Md. (1991)).

FIG. 23. Fab arm exchange of CH3 domain mutants of human IgG4antibodies. Mixtures of two recombinant human IgG4 antibodies (IgG4-CD20and IgG4-EGFr) and CH3 domain mutants thereof were incubated with 0.5 mMGSH for 24 h at 37° C. The formation of bispecific antibodies throughFab arm exchange was measured in a sandwich ELISA.

FIG. 24. Shows the location of primers used for the preparation of DNAconstructs.

DETAILED DESCRIPTION OF THE INVENTION Definitions

The term “immunoglobulin” refers to a class of structurally relatedglycoproteins consisting of two pairs of polypeptide chains, one pair oflight (L) low molecular weight chains and one pair of heavy (H) chains,all four inter-connected by disulfide bonds. The structure ofimmunoglobulins has been well characterized. See for instanceFundamental Immunology Ch. 7 (Paul, W., ed., 2nd ed. Raven Press, N.Y.(1989)). Briefly, each heavy chain typically is comprised of a heavychain variable region (abbreviated herein as V_(H) or VH) and a heavychain constant region. The heavy chain constant region typically iscomprised of three domains, C_(H)1, C_(H)2, and C_(H)3. Each light chaintypically is comprised of a light chain variable region (abbreviatedherein as V_(L) or VL) and a light chain constant region. The lightchain constant region typically is comprised of one domain, C_(L). TheV_(H) and V_(L) regions may be further subdivided into regions ofhypervariability (or hypervariable regions which may be hypervariable insequence and/or form of structurally defined loops), also termedcomplementarity determining regions (CDRs), interspersed with regionsthat are more conserved, termed framework regions (FRs). Each V_(H) andV_(L) is typically composed of three CDRs and four FRs, arranged fromamino-terminus to carboxy-terminus in the following order: FR1, CDR1,FR2, CDR2, FR3, CDR3, FR4 (see also Chothia and Lesk J. Mol. Biol. 196,901-917 (1987)).

Often, the numbering of amino acid residues is performed by the methoddescribed in Kabat et al., Sequences of Proteins of ImmunologicalInterest, 5th Ed. Public Health Service, National Institutes of Health,Bethesda, Md. (1991). Using this numbering system, the actual linearamino acid sequence of a peptide may contain fewer or additional aminoacids corresponding to a shortening of, or insertion into, a FR or CDRof the variable domain. For example, a heavy chain variable domain mayinclude a single amino acid insert (residue 52a according to Kabat)after residue 52 of V_(H) CDR2 and inserted residues (for instanceresidues 82a, 82b, and 82c, etc. according to Kabat) after heavy chainFR residue 82. The Kabat numbering of residues may be determined for agiven antibody by alignment at regions of homology of the sequence ofthe antibody with a “standard” Kabat numbered sequence.

Alternatively, the numbering of amino acid residues is performed by theEU-index also described in Kabat et al., Sequences of Proteins ofImmunological Interest, 5th Ed. Public Health Service, NationalInstitutes of Health, Bethesda, Md. (1991). This numbering is often usedin literature dealing with the Fc part of human immunoglobulin Gmolecules and is also used throughout this application.

FIG. 22 gives an overview of both numbering methods and shows analignment of different antibody isotypes based on anti-EGFR antibody2F8.

The term “antibody” (Ab) in the context of the present invention refersto an immunoglobulin molecule, a fragment of an immunoglobulin molecule,or a derivative of either thereof, which has the ability to specificallybind to an antigen under typical physiological conditions with a halflife of significant periods of time, such as at least about 30 minutes,at least about 45 minutes, at least about one hour, at least about twohours, at least about four hours, at least about 8 hours, at least about12 hours, about 24 hours or more, about 48 hours or more, about 3, 4, 5,6, 7 or more days, etc., or any other relevant functionally-definedperiod (such as a time sufficient to induce, promote, enhance, and/ormodulate a physiological response associated with antibody binding tothe antigen and/or time sufficient for the antibody to recruit anFc-mediated effector activity). The variable regions of the heavy andlight chains of the immunoglobulin molecule contain a binding domainthat interacts with an antigen. The constant regions of the antibodies(Abs) may mediate the binding of the immunoglobulin to host tissues orfactors, including various cells of the immune system (such as effectorcells) and components of the complement system such as C1q, the firstcomponent in the classical pathway of complement activation. Asindicated above, the term antibody herein, unless otherwise stated orclearly contradicted by context, includes fragments of an antibody thatcomprise a mutated or wildtype core hinge region and retain the abilityto specifically bind to the antigen.

It has been shown that the antigen-binding function of an antibody maybe performed by fragments of a full-length antibody. Although suchfragments are generally included within the meaning of antibody, theycollectively and each independently are unique features of the presentinvention, exhibiting different biological properties and utility. Italso should be understood that the term antibody, unless specifiedotherwise, also includes polyclonal antibodies, monoclonal antibodies(mAbs), antibody-like polypeptides, such as chimeric antibodies andhumanized antibodies, and antibody fragments retaining the ability tospecifically bind to the antigen (antigen-binding fragments) provided byany known technique, such as enzymatic cleavage, peptide synthesis, andrecombinant techniques.

The term “human antibody”, as used herein, is intended to includeantibodies having variable and constant regions derived from humangermline immunoglobulin sequences. The human antibodies of the inventionmay include amino acid residues not encoded by human germlineimmunoglobulin sequences (e.g., mutations introduced by random orsite-specific mutagenesis in vitro or by somatic mutation in vivo).However, the term “human antibody”, as used herein, is not intended toinclude antibodies in which CDR sequences derived from the germline ofanother mammalian species, such as a mouse, have been grafted onto humanframework sequences.

The term “chimeric antibody” refers to an antibody that contains one ormore regions from one antibody and one or more regions from one or moreother antibodies. The term “chimeric antibody” includes divalent andpolyvalent antibodies. Chimeric antibodies are produced by recombinantprocesses well known in the art (see for instance Cabilly et al., PNASUSA 81, 3273-3277 (1984), Morrison et al., PNAS USA 81, 6851-6855(1984), Boulianne et al., Nature 312, 643-646 (1984), EP125023,Neuberger et al., Nature 314, 268-270 (1985), EP171496, EP173494,WO86/01533, EP184187, Sahagan et al., J. Immunol. 137, 1066-1074 (1986),WO87/02671, Liu et al., PNAS USA 84, 3439-3443 (1987), Sun et al., PNASUSA 84, 214-218 (1987), Better et al., Science 240, 1041-1043 (1988) andHarlow et al., Antibodies: A Laboratory Manual, Cold Spring HarborLaboratory Press, Cold Spring Harbor, N.Y., (1988)).

A “humanized antibody” is an antibody that is derived from a non-humanspecies, in which certain amino acids in the framework and constantdomains of the heavy and light chains have been mutated so as to avoidor abrogate an immune response in humans. Humanized forms of non-human(for instance murine) antibodies are chimeric antibodies which containminimal sequence derived from non-human immunoglobulin. For the mostpart, humanized antibodies are human immunoglobulins (recipientantibody) in which residues from a hypervariable region of the recipientare replaced by residues from a hypervariable region of a non-humanspecies (donor antibody) such as mouse, rat, rabbit or nonhuman primatehaving the desired specificity, affinity, and capacity. In someinstances, Fv framework region (FR) residues of the human immunoglobulinare replaced by corresponding non-human residues. Furthermore, humanizedantibodies may comprise residues which are not found in the recipientantibody or in the donor antibody. These modifications are made tofurther refine antibody performance. In general, a humanized antibodywill comprise substantially all of at least one, and typically two,variable domains, in which all or substantially all of the hypervariableloops correspond to those of a non-human immunoglobulin and all orsubstantially all of the FR regions are those of a human immunoglobulinsequence. A humanized antibody typically also will comprise at least aportion of an immunoglobulin constant region (Fc), typically that of ahuman immunoglobulin. For further details, see Jones et al., Nature 321,522-525 (1986), Riechmann et al., Nature 332, 323-329 (1988) and Presta,Curr. Op. Struct. Biol. 2, 593-596 (1992).

An “isolated antibody” as used herein, is intended to refer to anantibody which is substantially free of other antibodies havingdifferent antigenic specificities. An isolated antibody thatspecifically binds to an epitope, isoform or variant of a particularhuman target antigen may, however, have cross-reactivity to otherrelated antigens, for instance from other species (such as specieshomologs). Moreover, an isolated antibody may be substantially free ofother cellular material and/or chemicals.

The terms “monoclonal antibody” or “monoclonal antibody composition” asused herein refer to a preparation of antibody molecules of singlemolecular composition. A monoclonal antibody composition displays asingle binding specificity and affinity for a particular epitope.Accordingly, the term “human monoclonal antibody” refers to antibodiesdisplaying a single binding specificity which have variable and constantregions derived from human germline immunoglobulin sequences. The humanmonoclonal antibodies may be generated by a hybridoma which includes a Bcell obtained from a transgenic or transchromosomal nonhuman animal,such as a transgenic mouse, having a genome comprising a human heavychain transgene and a light chain transgene, fused to an immortalizedcell.

As used herein, the term “binding” in the context of the binding of anantibody to a predetermined antigen typically is a binding with anaffinity corresponding to a K_(D) of about 10⁻⁷ M or less, such as about10⁻⁸ M or less, such as about 10⁻⁹ M or less, about 10⁻¹⁰ M or less, orabout 10⁻¹¹ M or even less when determined by for instance surfaceplasmon resonance (SPR) technology in a BIAcore 3000 instrument usingthe antigen as the ligand and the antibody as the analyte, and binds tothe predetermined antigen with an affinity corresponding to a K_(D) thatis at least ten-fold lower, such as at least 100 fold lower, forinstance at least 1000 fold lower, such as at least 10,000 fold lower,for instance at least 100,000 fold lower than its affinity for bindingto a non-specific antigen (e.g., BSA, casein) other than thepredetermined antigen or a closely-related antigen. The amount withwhich the affinity is lower is dependent on the K_(D) of the antibody,so that when the K_(D) of the antibody is very low (that is, theantibody is highly specific), then the amount with which the affinityfor the antigen is lower than the affinity for a non-specific antigenmay be at least 10,000 fold.

The term “k_(d)” (sec⁻¹), as used herein, refers to the dissociationrate constant of a particular antibody-antigen interaction. Said valueis also referred to as the k_(off) value.

The term “k_(a)” (M⁻¹×sec⁻¹), as used herein, refers to the associationrate constant of a particular antibody-antigen interaction.

The term “k_(D)” (M), as used herein, refers to the dissociationequilibrium constant of a particular antibody-antigen interaction.

The term “K_(A)” (M⁻¹), as used herein, refers to the associationequilibrium constant of a particular antibody-antigen interaction and isobtained by dividing the k_(a) by the k_(d).

As used herein, “isotype” refers to the immunoglobulin (sub)class, forinstance IgG1, IgG2, IgG3, IgG4, IgD, IgA, IgE, or IgM, that is encodedby heavy chain constant region genes.

As used herein, a human antibody is “derived from” a particular germlinesequence if the antibody is obtained from a system using humanimmunoglobulin sequences, for instance by immunizing a transgenic mousecarrying human immunoglobulin genes or by screening a humanimmunoglobulin gene library, and wherein the selected human antibody isat least 90%, such as at least 95%, for instance at least 96%, such asat least 97%, for instance at least 98%, or such as at least 99%identical in amino acid sequence to the amino acid sequence encoded bythe germline immunoglobulin gene. Typically, outside the heavy chainCDR3, a human antibody derived from a particular human germline sequencewill display no more than 20 amino acid differences, e.g. no more than10 amino acid differences, such as no more than 5, for instance no morethan 4, 3, 2, or 1 amino acid difference from the amino acid sequenceencoded by the germline immunoglobulin gene.

The term “bispecific antibody” is intended to include any antibody,which has two different binding specificities, i.e. the antibody bindstwo different epitopes, which may be located on the same target antigenor, more commonly, on different target antigens.

As used herein, the term “effector cell” refers to an immune cell whichis involved in the effector phase of an immune response, as opposed tothe cognitive and activation phases of an immune response. Exemplaryimmune cells include a cell of a myeloid or lymphoid origin, forinstance lymphocytes (such as B cells and T cells including cytolytic Tcells (CTLs)), killer cells, natural killer cells, macrophages,monocytes, eosinophils, polymorphonuclear cells, such as neutrophils,granulocytes, mast cells, and basophils. Some effector cells expressspecific Fc receptors and carry out specific immune functions. In someembodiments, an effector cell is capable of inducing antibody-dependentcellular cytotoxicity (ADCC), such as a natural killer cell, capable ofinducing ADCC. For example, monocytes, macrophages, which express FcRare involved in specific killing of target cells and presenting antigensto other components of the immune system, or binding to cells thatpresent antigens. In some embodiments, an effector cell may phagocytosea target antigen or target cell. The expression of a particular FcR onan effector cell may be regulated by humoral factors such as cytokines.For example, expression of FcγRI has been found to be up-regulated byinterferon γ (IFN-γ) and/or G-CSF. This enhanced expression increasesthe cytotoxic activity of FcγRI-bearing cells against targets. Aneffector cell can phagocytose or lyse a target antigen or a target cell.

“Treatment” refers to the administration of an effective amount of atherapeutically active compound of the present invention with thepurpose of easing, ameliorating, arresting or eradicating (curing)symptoms or disease states.

An “effective amount” refers to an amount effective, at dosages and forperiods of time necessary, to achieve a desired therapeutic result. Atherapeutically effective amount of an antibody may vary according tofactors such as the disease state, age, sex, and weight of theindividual, and the ability of the antibody to elicit a desired responsein the individual. A therapeutically effective amount is also one inwhich any toxic or detrimental effects of the antibody or antibodyportion are outweighed by the therapeutically beneficial effects.

The terms “half-molecule exchange” and “Fab arm exchange” are usedinterchangeably herein and refer to a type of protein modification forhuman IgG4, in which an IgG4 heavy chain and attached light chain(half-molecule) is swapped for a heavy-light chain pair from anotherIgG4 molecule. Thus, IgG4 molecules may acquire two distinct Fab armsrecognizing two distinct antigens (resulting in bispecific molecules)while their Fc domain structure remains unchanged. As shown herein, Fabarm exchange occurs naturally in vivo and can be induced in vitro bypurified blood cells or reducing agents such as reduced glutathione.

Further Aspects and Embodiments of the Invention

As described above, in a first main aspect, the invention relates to astabilized IgG4 antibody for use as a medicament, comprising a heavychain and a light chain, wherein said heavy chain comprises a human IgG4constant region having a substitution of the Arg residue at position409, the Phe residue at position 405 or the Lys residue at position 370,wherein said antibody optionally comprises one or more furthersubstitutions, deletions and/or insertions, with the proviso that if theantibody has a residue selected from the group consisting of: Lys, Ala,Thr, Met and Leu at the position corresponding to 409, then the antibodydoes not comprise a Cys-Pro-Pro-Cys sequence in the hinge region.

In one embodiment, the antibody, comprises a heavy chain and a lightchain, wherein said heavy chain comprises a human IgG4 constant regionhaving a residue selected from the group consisting of: Lys, Ala, Thr,Met and Leu at the position corresponding to 409 and/or a residueselected from the group consisting of: Ala, Val, Gly, Ile and Leu at theposition corresponding to 405, and wherein said antibody optionallycomprises one or more further substitutions, deletions and/orinsertions, but does not comprise a Cys-Pro-Pro-Cys sequence in thehinge region.

The numbers 405 and 409 refer to the Phe and Lys residues at positions405 and 409, respectively, using the numbering according to the EUindex, see also Example 38 and FIG. 22.

In a further main aspect, the invention relates to an isolatedstabilized IgG4 antibody, comprising a heavy chain and a light chain,wherein said heavy chain comprises a human IgG4 constant region having aresidue selected from the group consisting of: Lys, Ala, Thr, Met andLeu at the position corresponding to 409 and/or a residue selected fromthe group consisting of: Ala, Val, Gly, Ile and Leu at the positioncorresponding to 405, and wherein said antibody optionally comprisesfurther substitutions, deletions and/or insertions, but does notcomprise a Cys-Pro-Pro-Cys sequence in the hinge region and does notcomprise both a Lys at position 409 and a Leu at position 309.

In one embodiment, said antibody comprises a Lys, Ala, Thr, Met or Leuresidue at the position corresponding to 409.

In another embodiment, said antibody comprises a Lys, Thr, Met or Leuresidue at the position corresponding to 409.

In a further embodiment, said antibody comprises a Lys, Met or Leuresidue at the position corresponding to 409.

In a yet other embodiment, the CH3 region of the antibody has beenreplaced by the CH3 region of human IgG1, of human IgG2 or of humanIgG3.

In a further embodiment of the stabilized IgG4 antibody of theinvention, the antibody has a residue which is has a lower mass (in Da)than Phe at the position corresponding to 405.

In a further embodiment, said antibody comprises an Ala, Val, Gly, Ileor Leu residue at the position corresponding to 405.

In an even further embodiment, said antibody comprises an Ala or Leuresidue at the position corresponding to 405.

In a further embodiment of the stabilized IgG4 antibody of theinvention, the antibody has a Thr residue at the position correspondingto 370.

In an even further embodiment, the stabilized IgG4 antibody of theinvention does not comprise a substitution of the Leu residue at theposition corresponding to 235 by a Glu.

However, in another embodiment, said antibody does comprise asubstitution of the Leu residue at the position corresponding to 235 bya Glu.

In a further embodiment, the antibody of the invention may have beenfurther modified to even further reduce effector functions.

Accordingly, in one embodiment, the antibody of the invention comprisesone or more of the following substitutions: an Ala at position 234, anAla at position 236, an Ala at position 237, an Ala at position 297, anAla or Val at position 318, an Ala at position 320, an Ala or Gln atposition 322.

In another embodiment, the stabilized IgG4 antibody of the inventiondoes not comprise a Cys-Pro-Pro-Cys sequence in the hinge region.

In one embodiment, the stabilized IgG4 antibody of the inventioncomprises a CXPC or CPXC sequence in the hinge region, wherein X can beany amino acid except for proline.

In a further embodiment, the antibody of the invention does not comprisea CPRC sequence in the core hinge region and/or does not comprise anextended IgG3-like hinge region, such as the extended hinge region asset forth in FIG. 22 (between positions 228 and 229 in IgG3).

In one embodiment, the stabilized IgG4 antibody of the inventioncomprises a CPSC sequence in the hinge region.

As explained above, the antibody of the invention may contain furthermodifications. In one embodiment, the stabilized IgG4 antibody of theinvention comprises a constant heavy chain region comprising an aminoacid sequence selected from the group consisting of: SEQ ID NO:39, 40and 41 or a variant of said amino acid sequence having less than 25,such as less than 10, e.g. less than 9, 8, 7, 6, 5, 4, 3, or 2substitutions, deletions and/or insertions compared to said amino acidsequence.

Typically, the stabilized IgG4 antibody of the invention has a lowerability to activate effector functions as compared to IgG1 and IgG3,Thus, in one embodiment, said antibody is less efficient in mediatingCDC and/or ADCC than a corresponding IgG1 or IgG3 antibody having thesame variable regions. Assays for measuring CDC or ADCC activity arewell known in the art.

In one embodiment, the stabilized IgG4 antibody of the inventioncomprises a constant heavy chain region comprising the amino acidsequence set forth in SEQ ID NO:40.

In one embodiment of the invention, the stabilized IgG4 antibody isselected from the group consisting of: a human antibody, a humanizedantibody and a chimeric antibody.

In one further embodiment, the antibody of the invention comprises ahuman kappa light chain. In another embodiment, said antibody comprisesa human lambda light chain.

Typically, the stabilized IgG4 antibody of the invention is a bivalentantibody, for example an antibody which is bivalent even in the presenceof excess of irrelevant antibodies, as explained in Example 38.Furthermore, the stabilized IgG4 antibody of the invention is preferablya full-length antibody, i.e. not a fragment.

Methods for the production of antibodies are well-known in the art. In apreferred embodiment, antibodies of the invention are monoclonalantibodies. Monoclonal antibodies may e.g. be produced by the hybridomamethod first described by Kohler et al., Nature 256, 495 (1975), or maybe produced by recombinant DNA methods. Monoclonal antibodies may alsobe isolated from phage antibody libraries using the techniques describedin, for example, Clackson et al., Nature 352, 624-628 (1991) and Markset al., J. Mol. Biol. 222, 581-597 (1991). Monoclonal antibodies may beobtained from any suitable source. Thus, for example, monoclonalantibodies may be obtained from hybridomas prepared from murine splenicB cells obtained from mice immunized with an antigen of interest, forinstance in form of cells expressing the antigen on the surface, or anucleic acid encoding an antigen of interest. Monoclonal antibodies mayalso be obtained from hybridomas derived from antibody-expressing cellsof immunized humans or non-human mammals such as rats, dogs, primates,etc.

Further modifications, such as amino acid substitutions, deletions orinsertion as described above, may be performed using standardrecombinant DNA techniques well-known in the art.

In one embodiment, the antibody of the invention is a human antibody.Human monoclonal antibodies directed may be generated using transgenicor transchromosomal mice carrying parts of the human immune systemrather than the mouse system. Such transgenic and transchromosomic miceinclude mice referred to herein as HuMAb mice and KM mice, respectively,and are collectively referred to herein as “transgenic mice”.

The HuMAb mouse contains a human immunoglobulin gene miniloci thatencodes unrearranged human heavy (μ and γ) and κ light chainimmunoglobulin sequences, together with targeted mutations thatinactivate the endogenous μ and κ chain loci (Lonberg, N. et al., Nature368, 856-859 (1994)). Accordingly, the mice exhibit reduced expressionof mouse IgM or κ and in response to immunization, the introduced humanheavy and light chain transgenes, undergo class switching and somaticmutation to generate high affinity human IgG,κ monoclonal antibodies(Lonberg, N. et al. (1994), supra; reviewed in Lonberg, N. Handbook ofExperimental Pharmacology 113, 49-101 (1994), Lonberg, N. and Huszar,D., Intern. Rev. Immunol. Vol. 13 65-93 (1995) and Harding, F. andLonberg, N. Ann. N.Y. Acad. Sci 764 536-546 (1995)). The preparation ofHuMAb mice is described in detail in Taylor, L. et al., Nucleic AcidsResearch 20, 6287-6295 (1992), Chen, J. et al., International Immunology5, 647-656 (1993), Tuaillon et al., J. Immunol. 152, 2912-2920 (1994),Taylor, L. et al., International Immunology 6, 579-591 (1994), Fishwild,D. et al., Nature Biotechnology 14, 845-851 (1996). See also U.S. Pat.No. 5,545,806, U.S. Pat. No. 5,569,825, U.S. Pat. No. 5,625,126, U.S.Pat. No. 5,633,425, U.S. Pat. No. 5,789,650, U.S. Pat. No. 5,877,397,U.S. Pat. No. 5,661,016, U.S. Pat. No. 5,814,318, U.S. Pat. No.5,874,299, U.S. Pat. No. 5,770,429, U.S. Pat. No. 5,545,807, WO98/24884, WO 94/25585, WO 93/1227, WO 92/22645, WO 92/03918 and WO01/09187.

The HCo7 mice have a JKD disruption in their endogenous light chain(kappa) genes (as described in Chen et al., EMBO J. 12, 821-830 (1993)),a CMD disruption in their endogenous heavy chain genes (as described inExample 1 of WO 01/14424), a KCo5 human kappa light chain transgene (asdescribed in Fishwild et al., Nature Biotechnology 14, 845-851 (1996)),and a HCo7 human heavy chain transgene (as described in U.S. Pat. No.5,770,429).

The HCo12 mice have a JKD disruption in their endogenous light chain(kappa) genes (as described in Chen et al., EMBO J. 12, 821-830 (1993)),a CMD disruption in their endogenous heavy chain genes (as described inExample 1 of WO 01/14424), a KCo5 human kappa light chain transgene (asdescribed in Fishwild et al., Nature Biotechnology 14, 845-851 (1996)),and a HCo12 human heavy chain transgene (as described in Example 2 of WO01/14424).

In the KM mouse strain, the endogenous mouse kappa light chain gene hasbeen homozygously disrupted as described in Chen et al., EMBO J. 12,811-820 (1993) and the endogenous mouse heavy chain gene has beenhomozygously disrupted as described in Example 1 of WO 01/09187. Thismouse strain carries a human kappa light chain transgene, KCo5, asdescribed in Fishwild et al., Nature Biotechnology 14, 845-851 (1996).This mouse strain also carries a human heavy chain transchromosomecomposed of chromosome 14 fragment hCF (SC20) as described in WO02/43478.

Splenocytes from these transgenic mice may be used to generatehybridomas that secrete human monoclonal antibodies according to wellknown techniques. Such transgenic non-human animals, non-human animalscomprising an operable nucleic acid sequence coding for expression ofantibody used in the invention, non-human animals stably transfectedwith one or more target-encoding nucleic acid sequences, and the like,are additional features of the present invention.

Human monoclonal or polyclonal antibodies to be used in the presentinvention, or antibodies used in the present invention originating fromother species may also be generated transgenically through thegeneration of another non-human mammal or plant that is transgenic forthe immunoglobulin heavy and light chain sequences of interest andproduction of the antibody in a recoverable form therefrom. Inconnection with the transgenic production in mammals, antibodies may beproduced in, and recovered from, the milk of goats, cows, or othermammals. See for instance U.S. Pat. No. 5,827,690, U.S. Pat. No.5,756,687, U.S. Pat. No. 5,750,172 and U.S. Pat. No. 5,741,957.

Further, human or other antibodies to be used in the present inventionmay be generated through display-type technologies, including, withoutlimitation, phage display, retroviral display, ribosomal display, andother techniques, using techniques well known in the art and theresulting molecules may be subjected to additional maturation, such asaffinity maturation, as such techniques are well known in the art (seefor instance Hoogenboom et al., J. Mol. Biol. 227, 381 (1991) (phagedisplay), Vaughan et al., Nature Biotech 14, 309 (1996) (phage display),Hanes and Pluckthun, PNAS USA 94, 4937-4942 (1997) (ribosomal display),Parmley and Smith, Gene 73, 305-318 (1988) (phage display), Scott TIBS17, 241-245 (1992), Cwirla et al., PNAS USA 87, 6378-6382 (1990), Russelet al., Nucl. Acids Research 21, 1081-1085 (1993), Hoogenboom et al.,Immunol. Reviews 130, 43-68 (1992), Chiswell and McCafferty TIBTECH 10,80-84 (1992), and U.S. Pat. No. 5,733,743). If display technologies areutilized to produce antibodies that are not human, such antibodies maybe humanized.

In a further main aspect, the invention relates to a method forproducing a stabilized IgG4 antibody of the invention, said methodcomprising expressing a nucleic acid construct encoding said antibody ina host cell and optionally purifying said antibody. In one embodiment ofthis method, said stabilized IgG4 antibody does not comprise both a Lysat position 409 and a Leu at position 309.

In one embodiment, the antibody of the invention is linked to a compoundselected from the group consisting of: a cytotoxic agent; aradioisotope; a prodrug or drug, such as a taxane; a cytokine; and achemokine. Methods for linking (conjugating) such compounds to anantibody are well-known in the art. References to suitable methods havebeen given in WO 2004/056847 (Genmab).

In a further main aspect, the invention relates to a pharmaceuticalcomposition comprising a stabilized IgG4 antibody as defined hereinabove. The pharmaceutical compositions may be formulated withpharmaceutically acceptable carriers or diluents as well as any otherknown adjuvants and excipients in accordance with conventionaltechniques, such as those disclosed in Remington: The Science andPractice of Pharmacy, 19th Edition, Gennaro, Ed., Mack Publishing Co.,Easton, Pa., 1995.

The pharmaceutically acceptable carriers or diluents as well as anyother known adjuvants and excipients should be suitable for the chosencompound of the present invention and the chosen mode of administration.Suitability for carriers and other components of pharmaceuticalcompositions is determined based on the lack of significant negativeimpact on the desired biological properties of the chosen compound orpharmaceutical composition of the present invention (e.g., less than asubstantial impact (10% or less relative inhibition, 5% or less relativeinhibition, etc.) on antigen binding.

A pharmaceutical composition of the present invention may also includediluents, fillers, salts, buffers, detergents (e. g., a nonionicdetergent, such as Tween-80), stabilizers, stabilizers (e. g., sugars orprotein-free amino acids), preservatives, tissue fixatives,solubilizers, and/or other materials suitable for inclusion in apharmaceutical composition.

Actual dosage levels of the active ingredients in the pharmaceuticalcompositions of the present invention may be varied so as to obtain anamount of the active ingredient which is effective to achieve thedesired therapeutic response for a particular patient, composition, andmode of administration, without being toxic to the patient. The selecteddosage level will depend upon a variety of pharmacokinetic factorsincluding the activity of the particular compositions of the presentinvention employed, or the ester, salt or amide thereof, the route ofadministration, the time of administration, the rate of excretion of theparticular compound being employed, the duration of the treatment, otherdrugs, compounds and/or materials used in combination with theparticular compositions employed, the age, sex, weight, condition,general health and prior medical history of the patient being treated,and like factors well known in the medical arts.

A physician or veterinarian having ordinary skill in the art can readilydetermine and prescribe the effective amount of the pharmaceuticalcomposition required. For example, the physician or veterinarian couldstart doses of the compounds of the invention employed in thepharmaceutical composition at levels lower than that required in orderto achieve the desired therapeutic effect and gradually increase thedosage until the desired effect is achieved. In general, a suitabledaily dose of a composition of the invention will be that amount of thecompound which is the lowest dose effective to produce a therapeuticeffect. Such an effective dose will generally depend upon the factorsdescribed above. It is preferred that administration be intravenous,intramuscular, intraperitoneal, by inhalation or subcutaneous. Ifdesired, the effective daily dose of a therapeutic composition may beadministered as two, three, four, five, six or more sub-dosesadministered separately at appropriate intervals throughout the day,optionally, in unit dosage forms.

In one embodiment, a pharmaceutical composition of the present inventionis administered parenterally. The phrases “parenteral administration”and “administered parenterally” as used herein means modes ofadministration other than enteral and topical administration, usually byinjection, and include epidermal, intravenous, intramuscular,intraarterial, intrathecal, intracapsular, intraorbital, intracardiac,intradermal, intraperitoneal, intratendinous, transtracheal,subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid,intraspinal, intracranial, intrathoracic, epidural and intrasternalinjection and infusion.

Stabilized IgG4 antibodies of the invention can be used in the treatmentand/or prevention of a number of diseases, and be directed to an antigenselected from a broad variety of suitable target molecules. In oneembodiment of the invention, the antibody binds an antigen selected fromthe group consisting of: erythropoietin, beta-amyloid, thrombopoietin,interferon-alpha (2a and 2b), interferon-beta (1b), interferon-gamma,TNFR I (CD120a), TNFR II (CD120b), IL-1R type 1 (CD121a), IL-1R type 2(CD121b), IL-2, IL2R (CD25), IL-2R-beta (CD123), IL-3, IL-4, IL-3R(CD123), IL-4R (CD124), IL-5R (CD125), IL-6R-alpha (CD126), -beta(CD130), IL-8, IL-10, IL-11, IL-15, IL-15BP, IL-15R, IL-20, IL-21, TCRvariable chain, RANK, RANK-L, CTLA4, CXCR4R, CCR5R, TGF-beta1, -beta2,-beta3, G-CSF, GM-CSF, MIF-R (CD74), M-CSF-R (CD115), GM-CSFR (CD116),soluble FcRI, sFcRII, sFcRIII, FcRn, Factor VII, Factor VIII, Factor IX,VEGF, VEGFxxxb, alpha-4 integrin, Cd11a, CD18, CD20, CD38, CD25, CD74,FcalphaRI, FcepsilonRI, acetyl choline receptor, fas, fasL, TRAIL,hepatitis virus, hepatitis C virus, envelope E2 of hepatitis C virus,tissue factor, a complex of tissue factor and Factor VII, EGFr, CD4,CD28, VLA-1, 2, 3, or 4, LFA-1, MAC-1, 1-selectin, PSGL-1, ICAM-I,P-selectin, periostin, CD33 (Siglec 3), Siglec 8, TNF, CCL1, CCL2, CCL3,CCL4, CCL5, CCL11, CCL13, CCL17, CCL18, CCL20, CCL22, CCL26, CCL27,CX3CL1, LIGHT, EGF, VEGF, TGFalpha, HGF, PDGF, NGF, complement or arelated components such as: C1q, C4, C2, C3, C5, C6, C7, C8, C9, MBL,factor B, a Matrix Metallo Protease such as any of MMP1 to MMP28, CD32b,CD200, CD200R, Killer Immunoglobulin-Like Receptors (KIRs), NKG2D andrelated molecules, leukocyte-associated immunoglobulin-like receptors(LAIRs), Iy49, PD-L2, CD26, BST-2, ML-IAP (melanoma inhibitor ofapoptosis protein), cathepsin D, CD40, CD4OR, CD86, a B cell receptor,CD79, PD-1, and a T cell receptor.

In one embodiment of the invention, the antibody binds an alpha-4integrin and is for use in the treatment of inflammatory and autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma and sepsis.

In another embodiment of the invention, the antibody binds VLA-1, 2, 3,or 4 and is for use in the treatment of inflammatory and autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma, type-1 diabetes, SLE, psoriasis, atopicdermatitis, COPD and sepsis.

In another embodiment of the invention, the antibody binds a moleculeselected from the group consisting of: LFA-1, MAC-1, I-selectin andPSGL-1 and is for use in the treatment of inflammatory and autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma, type-1 diabetes, SLE, psoriasis, atopicdermatitis, and COPD.

In another embodiment of the invention, the antibody binds a moleculeselected from the group consisting of: LFA-1, MAC-1, I-selectin andPSGL-1 and is for use in the treatment of a disease selected from thegroup consisting of ischemia-reperfusion injury, cytic fibrosis,osteomyelitis, glomerulonepritis, gout and sepsis.

In another embodiment of the invention, the antibody binds CD18 and isfor use in the treatment of inflammatory and autoimmune diseases, suchas rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease,asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis and COPD.

In another embodiment of the invention, the antibody binds Cd11a and isfor use in the treatment of inflammatory and autoimmune diseases, suchas rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease,asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis and COPD.

In another embodiment of the invention, the antibody binds ICAM-1 and isfor use in the treatment of inflammatory and autoimmune diseases, suchas rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease,asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis and COPD.

In another embodiment of the invention, the antibody binds P-selectinand is for use in the treatment of cardiovascular diseases,post-thrombotic vein wall fibrosis, ischemia reperfusion injury,inflammatory diseases or sepsis.

In another embodiment of the invention, the antibody binds periostin andis for use in the treatment of malignant diseases and/or metastisingdiseases, such as ovary cancer, endometrial cancer, NSCLC, glioblastoma,brain-related tumors, breast cancer, OSCC, colon cancer, pancreaticcancer, HNSCC, kidney cancer, thymoma, lung cancer, skin cancer, larynxcancer, liver cancer, parotid tumors, gastric cancer, esophagus cancer,prostate cancer, bladder cancer and cancer of the testis.

In another embodiment of the invention, the antibody binds CD33 (Siglec3), is optionally coupled to a toxin, cytotoxic or cytostatic drug, andis for use in the treatment of tumors expressing CD33 or acute myeloidleukemia.

In another embodiment of the invention, the antibody binds Siglec 8 andis for use in the treatment of: asthma, inflammatory or autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma, type-1 diabetes, SLE, psoriasis, atopicdermatitis and COPD.

In another embodiment of the invention, the antibody binds nucleolin andis for use in the treatment of malignant diseases and/or metastisingdiseases, such as ovary cancer, cervical cancer, endometrial cancer,NSCLC, glioblastoma, brain-related tumors, breast cancer, OSCC, coloncancer, pancreatic cancer, HNSCC, kidney cancer, thymoma, lung cancer,skin cancer, larynx cancer, liver cancer, parotid tumors, gastriccancer, oesophagus cancer, prostate cancer, bladder cancer, cancer ofthe testis and lymphomas.

In another embodiment of the invention, the antibody binds TNF and isfor use in the treatment of: inflammatory and autoimmune diseases, suchas rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease,asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis, COPD andsepsis.

In another embodiment of the invention, the antibody binds CCL1, CCL2,CCL3, CCL4, CCL5, CCL11, CCL13, CCL17, CCL18, CCL20, CCL22, CCL26, CCL27or CX3CL1 and is for use in the treatment of:: atopic dermatitis,inflammatory and autoimmune diseases, such as rheumatoid arthritis,multiple sclerosis, inflammatory bowel disease, asthma, type-1 diabetes,SLE, psoriasis, COPD and sepsis.

In another embodiment of the invention, the antibody binds PD-1 and isfor use in restoring T cell function in HIV-1 infection and therapy ofAIDS.

In another embodiment of the invention, the antibody binds LIGHT and isfor use in the treatment of a disease selected from the group consistingof: hepatitis, inflammatory bowel disease, graft-versus-host disease(GVHD) and inflammation.

In another embodiment of the invention, the antibody binds EGF, VEGF,TGFalpha or HGF and is for use in the treatment of: malignant diseases,such as solid cancers.

In another embodiment of the invention, the antibody binds PDGF and isfor use in the treatment of: diseases in which abnormal cellproliferation cell migration and/or angiogenesis occurs, such asatherosclerosis, fibrosis, and malignant diseases.

In another embodiment of the invention, the antibody binds NGF and isfor use in the treatment of: neurological diseases, neurodegenerativediseases, such as Alzheimer's disease and Parkinson's disease, orcancer, such as prostate cancer.

In another embodiment of the invention, the antibody binds complement ora related components such as: C1q, C4, C2, C3, C5, C6, C7, C8, C9, MBL,or factor B and is for use in: diseases in which complement and relatedcomponents play a detrimental role, such as organ transplant rejection,multiple sclerosis, Guillain-Barré syndrome, hemolytic anemia,Paroxysmal Nocturnal Hemoglobinuria, stroke, heart attacks, burninjuries, age-related macular degeneration, asthma, lupus, arthritis,myasthenia gravis, anti-phospholipid syndrome, sepsis and ischemiareperfusion injury.

In another embodiment of the invention, the antibody binds a MatrixMetallo Protease such as any of MMP1 to MMP28 and is for use in thetreatment of: inflammatory and autoimmune diseases, cancer, includingmetastatic cancer; arthritis, inflammation, cardiovascular diseases,cerebrovascular diseases such as stroke or cerebral aneurysms, pulmonarydiseases such as asthma, ocular diseases such as corneal wound healingor degenerative genetic eye diseases, gastrointestinal diseases such asinflammatory bowel disease or ulcers, oral diseases such as dentalcaries, oral cancer or periodontitis, ischemia reperfusion injury orsepsis.

In another embodiment of the invention, the antibody binds CD32b and isfor use in enhancement of T-cell responses to tumor antigens andADCC/phagocytosis by macrophages, in combination with anothertherapeutic antibody; vaccination, immunotherapy of B-cell lymphoma's,asthma or allergy.

In another embodiment of the invention, the antibody binds CD200 orCD200R and is for use in the treatment of: asthma, rheumatoid arthritis,GVHD, other autoimmune diseases, or cancer, such as solid tumors orlymphomas.

In another embodiment of the invention, the antibody binds KillerImmunoglobulin-Like Receptors (KIRs), NKG2D or related molecules,leukocyte-associated immunoglobulin-like receptors (LAIRs), or Iy49 andis for use in the treatment of: cancer, such as solid tumors orlymphomas; asthma, rheumatoid arthritis, GVHD or other autoimmunediseases.

In another embodiment of the invention, the antibody binds PD-L2 and isfor use in the treatment of: cancer, asthma, or for use in vaccineenhancement.

In another embodiment of the invention, the antibody binds CD26 and isfor use in the treatment of: atherosclerosis, GVHD, or auto-immunediseases.

In another embodiment of the invention, the antibody binds BST-2 and isfor use in the treatment of: asthma, atherosclerosis, rheumatoidarthritis, psoriasis, Crohn's disease, ulcerative cholitis, atopicdermatitis, sepsis or inflammation.

In another embodiment of the invention, the antibody binds ML-IAP(melanoma inhibitor of apoptosis protein) and is for use in thetreatment of melanoma.

In another embodiment of the invention, the antibody binds cathepsin Dand is for use in the treatment of: malignant diseases such as breastcancer, ovarian cancer, glioma, NSCLC, bladder cancer, endometrialcancer, liver cancer, sarcoma, gastric cancer, SCCHN, prostate cancer orcolorectal cancer.

In another embodiment of the invention, the antibody binds CD40 or CD40Rand is for use in the treatment of: cancer, in particular B-celllymphomas, B-cell-related or -mediated diseases, autoimmune diseasessuch as psoriatic arthritis, rheumatoid arthritis, multiple sclerosis,psoriasis, Crohn's disease or ulcerative cholitis.

In another embodiment of the invention, the antibody binds CD86 and isfor use in conjunction with organ transplantation.

In another embodiment of the invention, the antibody binds a B cellreceptor and is for use in the treatment of: B-cell-related or -mediateddiseases, such as B cell lymphoma's, leukemia, autoimmune diseases,inflammation or allergy.

In another embodiment of the invention, the antibody binds CD79 and isfor use in the treatment of B-cell-related or -mediated diseases, suchas B-cell lymphomas, leukemia, autoimmune diseases, inflammation orallergy.

In another embodiment of the invention, the antibody binds a T cellreceptor and is for use in the treatment of T-cell-related or -mediateddiseases, such as T-cell lymphomas, leukemia, autoimmune diseases,inflammation or allergy.

In another embodiment of the invention, the antibody binds FcalphaRI andis for use in the treatment of a disease or disorder selected from:allergic asthma or other allergic diseases such as allergic rhinitis,seasonal/perennial allergies, hay fever, nasal allergies, atopicdermatitis, eczema, hives, urticaria, contact allergies, allergicconjunctivitis, ocular allergies, food and drug allergies, latexallergies, or insect allergies, or IgA nephropathy, such as IgApemphigus.

In another embodiment of the invention, the antibody binds CD25 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: transplant rejection, graft-versus-host disease,inflammatory, immune or autoimmune diseases, inflammatory orhyperproliferative skin disorders, lymphoid neoplasms, malignancies,hematological disorders, skin disorders, hepato-gastrointestinaldisorders, cardiac disorders, vascular disorders, renal disorders,pulmonary disorders, neurological disorders, connective tissuedisorders, endocrinological disorders, viral infections.

In another embodiment of the invention, the antibody binds IL-15 or theIL15 receptor and is for use in the treatment of a disease or disorderselected from the group consisting of: arthritides, gout, connectivedisorders, neurological disorders, gastrointestinal disorders, hepaticdisorders, allergic disorders, hematological disorders, skin disorders,pulmonary disorders, malignant disorders, endocrinological disorders,vascular disorders, infectious disorders, kidney disorders, cardiacdisorders, circulatory disorders, metabolic disorders, bone, disordersand muscle disorders.

In another embodiment of the invention, the antibody binds IL-8 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: palmoplantar pustulosis (PPP), psoriasis, or otherskin diseases, inflammatory, autoimmune and immune disorders, alcoholichepatitis and acute pancreatitis, diseases involving IL-8 mediatedangiogenesis.

In another embodiment of the invention, the antibody binds CD20 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: rheumatoid arthritis, (auto)immune and inflammatorydisorders, non-Hodgkin's lymphoma, B-CLL, lymphoid neoplasms,malignancies and hematological disorders, infectious diseases andconnective disorders, neurological disorders, gastrointestinaldisorders, hepatic disorders, allergic disorders, hematologicaldisorders, skin disorders, pulmonary disorders, malignant disorders,endocrinological disorders, vascular disorders, infectious disorders,kidney disorders, cardiac disorders, circulatory disorders, metabolicdisorders, bone and muscle disorders, and immune mediated cytopenia.

In another embodiment of the invention, the antibody binds CD38 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: tumorigenic disorders, immune disorders in whichCD38 expressing B cells, plasma cells, monocytes and T cells areinvolved, acute respiratory distress syndrome and choreoretinitis,rheumatoid arthritis, inflammatory, immune and/or autoimmune disordersin which autoantibodies and/or excessive B and T lymphocyte activity areprominent, skin disorders, immune-mediated cytopenias, connective tissuedisorders, arthritides, hematological disorders, endocrinopathies,hepato-gastrointestinal disorders, nephropathies, neurologicaldisorders, cardiac and pulmonary disorders, allergic disorders,ophthalmologic disorders, infectious diseases, gynecological-obstetricaldisorders, male reproductive disorders, transplantation-deriveddisorders,

In another embodiment of the invention, the antibody binds EGFr and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: cancers (over)expressing EGFr and other EGFrrelated diseases, such as autoimmune diseases, psoriasis, inflammatoryarthritis.

In another embodiment of the invention, the antibody binds CD4 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: rheumatoid arthritis, (auto)immune and inflammatorydisorders, cutaneous T cell lymphomas, non-cutaneous T cell lymphomas,lymphoid neoplasms, malignancies and hematological disorders, infectiousdiseases, and connective disorders, neurological disorders,gastrointestinal disorders, hepatic disorders, allergic disorders,hematologic disorders, skin disorders, pulmonary disorders, malignantdisorders, endocrinological disorders, vascular disorders, infectiousdisorders, kidney disorders, cardiac disorders, circulatory disorders,metabolic disorders, bone disorders, muscle disorders, immune mediatedcytopenia, and HIV infection/AIDS.

In another embodiment of the invention, the antibody binds CD28 and isfor use in the treatment of a disease or disorder selected from thegroup consisting of: an inflammatory disease, autoimmune disease andimmune disorder.

In another embodiment of the invention, the antibody binds tissuefactor, or a complex of Factor VII and tissue factor and is for use inthe treatment of a disease or disorder selected from the groupconsisting of: vascular diseases, such as myocardial vascular disease,cerebral vascular disease, retinopathy and macular degeneration, andinflammatory disorders.

In a further aspect, the invention relates to the use of a stabilizedIgG4 antibody that binds any of the antigen mentioned herein above forthe preparation of a medicament for the treatment of a disease ordisorder as mentioned herein above in connection with said targetantigen.

The present invention is further illustrated by the following exampleswhich should not be construed as further limiting.

EXAMPLES Example 1 Oligonucleotide Primers and PCR Amplification

Oligonucleotide primers were synthesized and quantified by IsogenBioscience (Maarssen, The Netherlands). Primers were dissolved in H₂O to100 pmol/μl and stored at −20° C. A summary of all PCR and sequencingprimers is given below. For PCR, PfuTurbo® Hotstart DNA polymerase(Stratagene, Amsterdam, The Netherlands) was used according to themanufacturer's instructions. Each reaction mix contained 200 μM mixeddNTPs (Roche Diagnostics, Almere, The Netherlands), 6.7 pmol of both theforward and reverse primer, 100 ng of genomic DNA or 1 ng of plasmid DNAand 1 unit of PfuTurbo® Hotstart DNA polymerase in PCR reaction buffer(supplied with polymerase) in a total volume of 20 μl. PCR reactionswere carried out with a TGradient Thermocycler 96 (Whatman Biometra,Goettingen, Germany) using a 32-cycle program: denaturing at 95° C. for2 min; 30 cycles of 95° C. for 30 sec, a 60-70° C. gradient (or anotherspecific annealing temperature) for 30 sec, and 72° C. for 3 min; finalextension at 72° C. for 10 min. If appropriate, the PCR mixtures werestored at 4° C. until further analysis or processing.

Example 2 Agarose Gel Electrophoresis

Agarose gel electrophoresis was performed according to Sambrook(Sambrook, Russell et al. 2000 Molecular cloning. A laboratory manual(third edition), Cold Spring Harbor Laboratory Press) using gels of 50ml, in 1× Tris Acetate EDTA buffer. DNA was visualized by the inclusionof ethidium bromide in the gel and observation under UV light. Gelimages were recorded by a CCD camera and an image analysis system(GeneGnome; Syngene, via Westburg B.V., Leusden, The Netherlands).

Example 3 Analysis and Purification of PCR Products and EnzymaticDigestion

Purification of desired PCR fragments was carried out using a MinElutePCR Purification Kit (Qiagen, via Westburg, Leusden, The Netherlands;product #28006), according to the manufacturer's instructions. IsolatedDNA was quantified by UV spectroscopy and the quality was assessed byagarose gel electrophoresis.

Alternatively, PCR or digestion products were separated by agarose gelelectrophoresis (e.g. when multiple fragments were present) using a 1%Tris Acetate EDTA agarose gel. The desired fragment was excised from thegel and recovered using the QIAEX II Gel Extraction Kit (Qiagen; product#20051), according to the manufacturer's instructions.

Example 4 Quantification of DNA by UV Spectroscopy

Optical density of nucleic acids was determined using a NanoDrop ND-1000Spectrophotometer (Isogen Life Science, Maarssen, The Netherlands)according to the manufacturer's instructions. The DNA concentration wasmeasured by analysis of the optical density (OD) at 260 nm (oneOD_(260 nm) unit=50 μg/ml). For all samples, the buffer in which thenucleic acids were dissolved was used as a reference.

Example 5 Restriction Enzyme Digestions

Restriction enzymes and supplements were obtained from New EnglandBiolabs (Beverly, Mass., USA) or Fermetas (Vilnius, Lithuania) and usedaccording to the manufacturer's instructions.

DNA (100 ng) was digested with 5 units of enzyme(s) in the appropriatebuffer in a final volume of 10 μl (reaction volumes were scaled up asappropriate). Digestions were incubated at the recommended temperaturefor a minimum of 60 min. For fragments requiring double digestions withrestriction enzymes which involve incompatible buffers or temperaturerequirements, digestions were performed sequentially. If necessarydigestion products were purified by agarose gel electrophoresis and gelextraction.

Example 6 Ligation of DNA Fragments

Ligations of DNA fragments were performed with the Quick Ligation Kit(New England Biolabs) according to the manufacturer's instructions. Foreach ligation, vector DNA was mixed with approximately three-fold molarexcess of insert DNA.

Example 7 Transformation of E. Coli

Plasmid DNA (1-5 μl of DNA solution, typically 2 μl of DNA ligation mix)was transformed into One Shot DH5α-T1^(R) or MACH-1 T1^(R) competent E.coli cells (Invitrogen, Breda, The Netherlands; product #12297-016)using the heat-shock method, according to the manufacturer'sinstructions. Next, cells were plated on Luria-Bertani (LB) agar platescontaining 50 μg/ml ampicillin. Plates were incubated for 16-18 h at 37°C. until bacterial colonies became evident.

Example 8 Screening of Bacterial Colonies by PCR

Bacterial colonies were screened for the presence of vectors containingthe desired sequences via colony PCR using the HotStarTaq Master Mix Kit(Qiagen; product #203445) and the appropriate forward and reverseprimers. Selected colonies were lightly touched with a 20 μl pipette tipand touched briefly in 2 ml LB for small scale culture, and thenresuspended in the PCR mix. PCR was performed with a TGradientThermocycler 96 using a 35-cycle program: denaturation at 95° C. for 15min; 35 cycles of 94° C. for 30 sec, 55° C. for 30 sec and 72° C. for 2min; followed by a final extension step of 10 min at 72° C. Ifappropriate, the PCR mixtures were stored at 4° C. until analysis byagarose gel electrophoresis.

Example 9 Plasmid DNA Isolation from E. Coli Culture

Plasmid DNA was isolated from E. coli cultures using the following kitsfrom Qiagen (via Westburg, Leusden, The Netherlands), according to themanufacturer's instructions. For bulk plasmid preparation (50-150 mlculture), either a HiSpeed Plasmid Maxi Kit (product #12663) or aHiSpeed Plasmid Midi Kit (product #12643) was used. For small scaleplasmid preparation (±2 ml culture) a Qiaprep Spin Miniprep Kit (product#27106) was used and DNA was eluted in 50 μl elution buffer (suppliedwith kit).

Example 10 DNA Sequencing

Plasmid DNA was sequenced using standard procedures known in the art.Sequences were analyzed using Vector NTI software (Informax, Oxford,UK).

Example 11 Transient Expression in HEK-293F Cells

Freestyle™ 293-F (a HEK-293 subclone adapted to suspension growth andchemically defined Freestyle medium, e. g. HEK-293F) cells were obtainedfrom Invitrogen and transfected according to the manufacturer's protocolusing 293fectin (Invitrogen).

Example 12 Construction of pTomG4; A Vector for the Expression ofVariable Heavy Chain Regions with the Constant Region of Human IgG4

Genomic DNA was isolated from a blood sample of a volunteer and used asa template in a PCR with primers IGG4gene2f and IGG4gene2r (see tablebelow), amplifying the complete genomic constant region of the heavychain of IgG4 and introducing suitable restriction sites for cloninginto the mammalian expression vector pEE6.4 (Lonza Biologics). The PCRfragment was purified and cloned into pEE6.4. For this the PCR productwas digested with HindIII and EcoRI, followed by heat inactivation ofthe restriction enzymes. The pEE6.4 vector was digested HindIII andEcoRI, followed by heat inactivation of the restriction enzymes anddephosphorylation of the vector fragment with shrimp alkalinephosphatase, followed by heat inactivation of the phosphatase. The IgG4fragment and the pEE6.4HindIII/EcoRI dephosphorylated vector wereligated and transformed into competent MACH1-T1^(R) cells (Invitrogen).Three clones were grown in LB and plasmid DNA was isolated from a smallculture (1.5 mL). Restriction digestion revealed a pattern consistentwith the cloning of the IgG4 fragment in the pEE6.4 vector. Plasmid DNAfrom two clones was transformed in DH5α-T1^(R) E. coli and plasmid DNAwas isolated and the constructs were checked by sequence analysis of theinsert and one clone was found to be identical to a genomic IgG4 clonefrom the Genbank database, apart from some minor differences in introns.These differences are presumably either polymorphisms or sequence faultsin the Genbank sequence. The plasmid was named pTomG4.

TABLE 1 primer sequences Name Oligonucleotide Sequence VLexbetv1revAGCCACCGTACGTTTGATTTCCAGCTTGGTGCCTCC (SEQ ID NO: 1) VLex betv1forGATGCAAGCTTGCCGCCACCATGGAGTCACAGATTCAGGCATTT (SEQ ID NO: 2) VHexbetv1revCGATGGGCCCTTGGTGCTGGCTGAGGAGACGGTGACTGAGGT (SEQ ID NO: 3) VHexbetv1forGATGCAAGCTTGCCGCCACCATGAAATGCAGCTGGGTTATCTTC (SEQ ID NO: 4) VLexfeld1revAGCCACCGTACGTTTTATTTCCAACTTTGTCCCCGA (SEQ ID NO: 5) VLex feld1forGATGCAAGCTTGCCGCCACCATGGAATCACAGACTCAGGTCCTC (SEQ ID NO: 6) VHexfeld1revCGATGGGCCCTTGGTGCTGGCTGCAGAGAAAGTGACCAGAGT (SEQ ID NO: 7) VHexfeld1forGATGCAAGCTTGCCGCCACCATGGGATGGAGCTATATCATCCTC (SEQ ID NO: 8) IGG4gene2rTGAGAATTCGGTGGGTGCTTTATTTCCATGCT (SEQ ID NO: 9) IGG4gene2fGTAGAAGCTTACCATCGCGGATAGACAAGAACC (SEQ ID NO: 10) RACEKmm1TGTTAACTGCTCACTGGATGGTGGGA (SEQ ID NO: 11) RACEG1mm1TCCCTGGGCACAATTTTCTTGTCCACC (SEQ ID NO: 12) ShortUPMH3TGAAAGCTTCTAATACGACTCACTATAGGGC (SEQ ID NO: 13) LongUPMH3TGAAAGCTTCTAATACGACTCACTATAGGGCAAGCAGTGGTATCAACG CAGAGT (SEQ ID NO: 14)

Example 13 Cloning of the Variable Regions of the Mouse Anti-Betv1 andAnti-Feld1 Antibodies

Total RNA was prepared from 0.3×10⁵ (Betv1) or 0.9×10⁵ (Feld1) mousehybridoma cells (For Betv1: clone 2H8 from Akkerdaas, van Ree et al.1995 Allergy 50(3), 215-220 and for Feld1: clone 4F7 from de Groot etal. 1988 J. Allergy Clin. Immunol. 82, 778) with the RNeasy kit (Qiagen,Westburg, Leusden, Netherlands) according to the manufacturer'sprotocol.

5′-RACE-Complementary DNA (cDNA) of RNA was prepared from approximately100 ng total RNA, using the SMART RACE cDNA Amplification kit (BDBiosciences Clontech, Mountain View, Calif., USA), following themanufacturer's protocol. The VL and VH regions of the Betv1 and Feld1antibody were amplified by PCR. For this PfuTurbo® Hotstart DNApolymerase (Stratagene) was used according to the manufacturer'sinstructions. Each reaction mix contained 200 μM mixed dNTPs (RocheDiagnostics), 12 pmol of the reverse primer (RACEG1mm1 for the VH regionand RACEKmm1 for the VL region), 7.2 pmol UPM-Mix (UPM-Mix: 2 μMShortUPMH3 and 0.4 μM LongUPMH3 oligonucleotide), 0.6 μl of the 5′RACEcDNA template as described above, and 1.5 unit of PfuTurbo® Hotstart DNApolymerase in PCR reaction buffer (supplied with polymerase) in a totalvolume of 30 μl.

PCR reactions were carried out with a TGradient Thermocycler 96 (WhatmanBiometra) using a 35-cycle program: denaturing at 95° C. for 2 min; 35cycles of 95° C. for 30 sec, a 55° C. for 30 sec, and 72° C. for 1.5min; final extension at 72° C. for 10 min. The reaction products wereseparated by agarose gel electrophoresis on a 1% TAE agarose gel andstained with ethidium bromide. Bands of the correct size were cut fromthe gels and the DNA was isolated from the agarose using the QiaexII gelextraction kit (Qiagen).

Gel isolated PCR fragments were A tailed by a 10 min 72° C. incubationwith 200 μM dATP and 2.5 units Amplitaq (Perkin Elmer) and purifiedusing minielute columns (Qiagen). A-tailed PCR fragments were clonedinto the pGEMTeasy vector (Promega) using the pGEMT easy vector systemII kit (Promega), following the manufacturer's protocol. 2 μl of theligation mixture was transformed into OneShot DH5αT1R competent E. coli(Invitrogen) and plated on LB/Amp/IPTG/Xgal plates. Four, insertcontaining, white colonies each for the VH and VL sequences were pickedand the inserts were sequenced. The deduced amino acid sequences of theVH and VL of Betv1 are given in SEQ ID NO:15 and 16 and the deducedamino acid sequences of Feld1 are depicted in SEQ ID NO:17 and 18.

VH sequence Betv1 (SEQ ID NO: 15):mkcswvifflmavvtgvnsevqlqqsgaelvkpgasvklsctasgfnikdtyihwvkqrpeqglewvgridpatgntrydpkfqgkatitadtssntaylqlssltsedtavyycasfrpgyaldywgqgtsvtvss VL sequence Betv1 (SEQ ID NO: 16):mesqiqafvfvflwlsgvdgdlvmtqshkfmstsvgdrvsftckasqdvftavawyqqkpgqspklliywastrrtgvpdrftgsgsgtdytltissvqaedlalyycqqhfstpptfgggtkleik VH sequence Feld1 (SEQ ID NO: 17):mgwsyiilflvatatdvhsqvqlqqpgaelvkpgasvklsckasgysftsywmhwlkqrpgqglewigeinpnngrtyynekfktkatltvdkssstaymqlnsltsedsavyycarrltmvesfaywgqgtlvtfsa VL sequence Feld1 (SEQ ID NO:18): mesqtqvlmsllfwvsgtcgdivmtqspssltvtagekvtmsckssqsllnsgnqknyltwyqqkpgqppklliywastresgvpdrftgsgsgtdfsltissvqaedlaiyycqndysypftfgsgtkleik

Example 14 Construction of pConG1fBetV1: A Vector for the Production ofthe Heavy Chain of Betv1 -1 gG1

The V_(H) coding region of mouse anti-BetV1 antibody was amplified byPCR from a plasmid containing this region (example 13) using the primersVHexbetv1for and VHexbetv1rev, introducing suitable restriction sitesfor cloning into pConG1f0.4 and an ideal Kozak sequence. The VH fragmentwas gel purified and cloned into pConG1f0.4. For this the PCR productand the pConKappa0.4 vector were digested with HindIII and ApaI andpurified. The V_(H) fragment and the pConG1f0.4HindIII-ApaI digestedvector were ligated and transformed into competent DH5α-T1^(R) cells. Aclone was selected containing the correct insert size and the correctsequence was confirmed. This plasmid was named pConG1fBetv1.

Example 15 Construction of pConKBetv1: A Vector for the Production ofthe Light Chain of Betv1

The V_(L) coding region mouse anti-BetV1 antibody was amplified from aplasmid containing this region (example 13) using the primersVLexbetv1for and VLexbetv1rev, introducing suitable restriction sitesfor cloning into pConK0.4 and an ideal Kozak sequence. The PCR productand the pConKappa0.4 vector were digested with HindIII and BsiWI andpurified. The V_(L) fragment and the pConKappa0.4HindIII-BsiWI digestedvector were ligated and transformed into competent DH5α T1^(R) E. coli.A clone was selected containing the correct insert size and the sequencewas confirmed. This plasmid was named pConKBetv1.

Example 16 Construction of pTomG4Betv1: A Vector for the Production ofthe Heavy Chain of Betv1-IgG4

To construct a vector for expression of Betvl-IgG4, the VH region ofBetV1 was cloned in pTomG4. For this, pTomG4 and pConG1fBetv1 weredigested with HindIII and ApaI and the relevant fragments were isolated.The Betv1 V_(H) fragment and the pTomG4HindIII-ApaI digested vector wereligated and transformed into competent DH5α-T1^(R) cells. A clone wasselected containing the correct insert size and the sequence wasconfirmed. This plasmid was named pTomG4Betv1.

Example 17 Construction of pConG1fFeld1: A Vector for the Production ofthe Heavy Chain of Feld1-IgG1

The V_(H) coding region of mouse anti-Feld1 antibody was amplified byPCR from a plasmid containing this region (example 13) using the primersVHexfeld1for and VHexfeld1rev, introducing suitable restriction sitesfor cloning into pConG1f0.4 and an ideal Kozak sequence. The VH fragmentwas gel purified and cloned into pConG1f0.4. For this the PCR productand the pConKappa0.4 vector were digested with HindIII and ApaI andpurified. The V_(H) fragment and the pConG1f0.4HindIII-ApaI digestedvector were ligated and transformed into competent DH5α-T1^(R) cells. Aclone was selected containing the correct insert size and the correctsequence was confirmed. This plasmid was named pConG1fFeld 1.

Example 18 Construction of pConKFeld1: A Vector for the Production ofthe Light Chain of Feld1

The V_(L) coding region mouse anti-'Feld1 antibody was amplified from aplasmid containing this region (example 13) using the primersVLexfeld1for and VLexfeld1rev, introducing suitable restriction sitesfor cloning into pConK0.4 and an ideal Kozak sequence. The PCR productand the pConKappa0.4 vector were digested with HindIII and BsiWI andpurified. The V_(L) fragment and the pConKappa0.4HindIII-BsiWI digestedvector were ligated and transformed into competent DH5α T1^(R) E. coli.A clone was selected containing the correct insert size and the sequencewas confirmed. This plasmid was named pConKFeld1.

Example 19 Construction of pTomG4Feld1: A Vector for the Production ofthe Heavy Chain of Feld1-IgG4

To construct a vector for expression of Feld1-IgG4, the VH region ofFeld1 was cloned in pTomG4. For this, pTomG4 and pConG1f Feld1 weredigested with HindIII and ApaI and the relevant fragments were isolated.The Feld1 V_(H) fragment and the pTomG4HindIII-ApaI digested vector wereligated and transformed into competent DH5α-T1^(R) cells. A clone wasselected containing the correct insert size and the sequence wasconfirmed. This plasmid was named pTomG4Feld1.

Example 20 Construction of Antibody Expression Vectors for theExpression of 2F8-IgG4 and 7D8-IgG4

Expression vectors for the expression of HuMab 2F8 (IgG1-EGFR) and HuMab7D8 (IgG1-CD20) were constructed. The VH and VL coding regions of HuMab2F8 (WO 02/100348) and HuMab 7D8 (WO 04/035607) were cloned in theexpression vector pConG1f (Lonza Biologics) for the production of theIgG1 heavy chain and pConKappa for the production of the kappa lightchain, yielding the vectors pConG1f2F8, pConG1f7D8, pConKappa2F8 andpConKappa7D8. The VH regions of pConG1f2F8 and pConG1f7D8 were removedfrom these vectors by a HindIII/ApaI digestion and inserted into aHindIII/ApaI digested pTomG4 vector, resulting in pTomG42F8 andpTomG47D8 respectively.

Example 21 Production of Betv1-IgG1, Betv1-IgG4, Feld1-IgG1 andFeld1-IgG4 by Transient Expression in HEK-293F Cells

Antibodies were produced from all constructs by cotransfecting therelevant heavy and light chain vectors in HEK-293F cells using 293fectinaccording to the manufacturer's instructions. For Betv1-IgG1,pConG1Betv1 and pConKBetv1 were coexpressed. For Betv1-IgG4, pTomG4Betv1and pConKBetv1 were coexpressed. For Feld1-IgG1, pConG1Feld1 andpConKFeld1 were coexpressed. For Feld1-IgG4, pTomG4Feld1 and pConKFeld1were coexpressed. For IgG1-EGFr, pConG1f2F8 and pConKappa2F8 werecoexpressed. For IgG4-EGFr, pTomG42F8 and pConKappa2F8 were coexpressed.For IgG1-CD20, pConG1f7D8 and pConKappa7D8 were coexpressed. ForIgG4-CD20, pTomG47D8 and pConkappa7D8 were coexpressed.

Example 22 Purification of IgG1 and IgG4 Antibodies

IgG1 and IgG4 antibodies were purified by protein A affinitychromatography. The cell culture supernatants were filtered over a 0.20μM dead-end filter, followed by loading on a 5 ml Protein A column(rProtein A FF, GE Healthvcare) and elution of the IgG with 0.1 M citricacid-NaOH, pH 3. The eluate was immediately neutralized with 2 MTris-HCl, pH 9 and dialyzed overnight to 12.6 mM sodium phosphate, 140mM NaCl, pH 7.4 (B. Braun, Oss, The Netherlands). After dialysis,samples were sterile filtered over a 0.20 μM dead-end filter.Concentration of the purified IgGs was determined by nephelometry andabsorbance at 280 nm. Purified proteins were analyzed by SDS-PAGE, IEF,Mass spectrometry and Glycoanalysis.

Example 23 SDS-PAGE Analysis of Purified IgGs

After purification, the Betv1 and Feldl, IgG1 and IgG4 antibodies wereanalyzed on non-reducing SDS-PAGE. The Bis-Tris electrophoresis methodused is a modification of the Laemmli method (Laemmli 1970 Nature227(5259): 680-5), where the samples were run at neutral pH. TheSDS-PAGE gels were stained with Coomassie and digitally imaged using theGeneGenius (Synoptics, Cambridge, UK).

As can be seen in FIG. 1, Betv1 and Feld1 IgG1 showed 1 major bandrepresenting the full length tetrameric (2 heavy and two light chains)Feld1 and Betv1 IgG1 molecules. Betv1 and Feld1 IgG4 showed to have,besides the major band representing the tetrameric IgG4 molecule,substantial amounts of half-molecules (i.e. one heavy band one lightchain).

Example 24 Evaluation of IgG4 Fab Arm Exchange in Mice

Five nu/nu Balb/c mice 6-8 weeks of age were used to follow the exchangeof IgG4 half molecules. The mice were housed in a barrier unit of theCentral Laboratory Animal Facility (Utrecht, The Netherlands) and keptin filter-top cages with water and food provided ad libitum. Allexperiments were approved by the Utrecht University animal ethicscommittee.

Chimeric antibodies were administered intraperitoneally. Blood samples(75-100 μl) were drawn at 4.25 hours, 24 hours, 48 hours and 72 hoursafter administration. Blood was collected in heparin-containing vialsand centrifuged for 5 minutes at 10.000 g to separate plasma from cells.Plasma was stored at −20° C. for determination of antigen specificantibody and bispecific antibody levels.

In this experiment the exchange of chimeric IgG4 half molecules (n=2)was compared with the exchange of IgG1 half molecules (n=3). Mixtures ofBet v 1 and Fel d 1 specific antibodies (IgG1 or IgG4) were administeredto the mice at a dose of 600 μg (300 μg of each antigen specificantibody) in 200 μl per mouse.

Plasma concentrations of Bet v 1 or Fel d 1 binding antibodies weremeasured in the antigen binding test. To this end, plasma samples wereincubated with 0.75 mg of protein G Sepharose (Amersham Biosciences,Uppsala, Sweden) in 750 μl PBS-IAT (PBS supplemented with 1 μg/ml IVIg,0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃) in thepresence of ¹²⁵I-labeled Bet v 1 or ¹²⁵I-labeled Fel d 1 for 24 h. Next,the Sepharose was washed with PBS-T (PBS supplemented with 0.1% Tween-20and 0.05% (w/v) NaN₃) and the amount of radioactivity bound relative tothe amount of radioactivity added was measured. The concentration of Betv 1 or Fel d 1 specific IgG was calculated using purified Bet v 1specific antibodies or Fel d 1 specific antibodies as a standard (range0-200 ng per test as determined by nephelometer). The concentration ofbispecific IgG was measured in two variants of the heterologouscross-linking assay. In the first assay, plasma was incubated for 24 hwith Sepharose-coupled Bet v 1 (0.5 mg) in a total volume of 300 μl inPBS-IAT. Subsequently, the Sepharose was washed with PBS-T and incubatedfor 24 h with ¹²⁵I-labeled Fel d 1, after which the Sepharose was washedwith PBS-T and the amount of radioactivity bound relative to the amountof radioactivity added was measured. The concentration of bispecific IgG(Bet v 1-Fel d 1) was calculated using the calibration curve of the Feld 1 binding test, which was obtained from purified Fel d 1 binding rIgG.In the second assay Fel d 1-Bet v 1 cross-linking activity was measuredin a similar procedure using Sepharose-coupled rFel d 1 (0.5 mg) and¹²⁵I-labeled Bet v 1. The concentration of bispecific IgG (Fel d 1-Betv 1) was calculated using purified Bet v 1 specific rIgG as a standard(same curve as in Bet v 1 binding test).

In FIG. 2 the concentration of bispecific IgG (Fel d 1-Bet v 1) isplotted versus the concentration of Bet v 1 binding IgG at differenttime points. No bispecific IgG was observed in the mice dosed with IgG1mixes in contrast to the mice dosed with IgG4. After 24 h the generationof bispecific IgG4 was maximal and corresponded to an exchange of 100%.

In FIG. 3A the formation of bispecific IgG4 is followed in time.Bispecific antibodies appeared in time in the plasma of mice injectedwith mixtures of IgG4, but not IgG1, with bispecific reactivityachieving a maximum of almost 50% after 1-2 days incubation (note: ifequal amounts of IgG4-Betv1 and IgG4-Feld1 are exchanged, maximal 50% ofthe IgG4-Betv1 half-antibodies will be incorporated in the bispecificfraction after random and complete exchange of half-antibodies). Arandom Fab arm exchange between equal amounts of IgG4-Betv1 andIgG4-Feldl, would be consistent with approximately half of the IgG4molecules acquiring bispecificity. As a control, a 20-fold-excess of anadditional IgG4 directed against an irrelevant antigen (IgG4 generatedfrom anti-EGFr antibody 2F8) was injected in mice together withIgG4-Betv1 and IgG4-Feld1. The excess irrelevant IgG4 competed with thegeneration of Betv1-Feld1-bispecific IgG4.

In another experiment (FIG. 3B) the same murine plasma samples weretested for their ability to cross-link radio-labeled soluble Fel d 1 toSepharose-immobilized Fel d 1. It was found that the monospecificcross-linking activity was decreased in mice dosed with an equal mixtureof IgG4s but not IgGls, indicating a loss of monospecific cross-linkingactivity. A maximal reduction of ˜50% was reached after about one day.In mice dosed with the additional excess of irrelevant IgG4,monospecific cross-linking activity almost completely disappeared withsimilar kinetics.

Size-exclusion chromatography was performed to exclude the possibilitythat bispecific activity observed in the mice dosed with IgG4 was theresult of IgG aggregation (FIG. 4). For this purpose, a plasma sample(drawn at t=24 h) was fractionated on a Superdex200 column, after whichFel d 1 binding IgG and Bet v 1-Fel d 1 cross-linking IgG were measuredin the fractions. Fel d 1 binding antibodies eluted in one peak with aretention volume of ˜12.9 ml, which corresponds to the retention volumeof monomeric IgG. The heterologous Bet v 1-Fel d 1 cross-linkingactivity was detected in the same fractions indicating that bispecificactivity was associated with monomeric IgG. In the rIgG1 containingplasma no Bet v 1-Fel d 1 cross-linking activity was present beforefractionation. Also in the eluted fractions no heterologouscross-linking activity was measured (data not shown).

Example 25 Evaluation of Fab Arm Exchange Activity by Whole Blood(Components)

Chimeric antibodies were mixed and subsequently incubated with wholeblood, blood cells, plasma or serum to investigate the exchange activityof whole blood (components).

In this experiment the exchange of IgG4 half molecules was evaluated inwhole blood from two healthy blood donors, A and B, in which theendogenous plasma level of IgG4 was determined by nephelometry (being346 and 554 μg/ml, respectively). Whole blood was obtained invacutainers supplemented with TFPI (Tissue Factor Pathway Inhibitor fromChiron Corporation, Emeryville, Calif.) in a final concentration of 40μg/ml. Blood cells and plasma were obtained by centrifugation of wholeblood. The cellular fraction was washed 3 times with Optimem(Invitrogen, Breda, The Netherlands) and subsequently resuspended inOptimem. Serum was obtained by incubating whole blood in a glassvacutainer with clot activator for 30 min at 37° C., after which theclotted blood was spinned down. The exchange of IgG4 half molecules wasevaluated and compared to the exchange of IgG1 half molecules. As acontrol the blood samples were also incubated in the absence of chimericantibodies. The following antibodies mixtures were prepared in PBS:

1. Bet v 1 specific IgG4 (10 μg) and Fel d 1 specific IgG4 (10 μg)

2. Bet v 1 specific IgG1 (10 μg) and Fel d 1 specific IgG1 (10 μg)

These antibody mixtures were incubated with blood, blood cells, plasmaor serum in a total volume of 100 μl (final concentration for eachantibody was 0.1 μg/ml) on a horizontal orbital shaker (125 rpm) at 37°C. Final hematocrit in the incubation mixtures with whole blood andblood cells was around ˜40%. After 24 h the incubation mixtures werecentrifuged for 1 min at 2800 rpm in an Eppendorf centrifuge, afterwhich a sample of 10 μl was drawn in 500 μl PBS-AT (PBS supplementedwith 0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃).Samples were stored, if necessary, at 4° C.

Bispecific activity (i.e. Fel d 1-Bet v 1 cross-linking activity) wasmeasured in the heterologous cross-linking assay. In this assay, asample was incubated for 24 h with 0.5 mg Sepharose-coupled recombinantFel d 1 in a total volume of 300 μl in PBS-IAT (PBS-AT supplemented with1 μg/ml IVIg). Subsequently, the Sepharose was washed with PBS-T andincubated for 24 h with ¹²⁵I-labeled Bet v 1, after which the Sepharosewas washed with PBS-T and the amount of radioactivity bound relative tothe amount of radioactivity added was measured.

In FIG. 5 bispecific activity is represented as percentage bound¹²⁵I-labeled Bet v 1, which was determined in the heterologouscross-linking assay. Bispecific activity is a measure for the exchangeof IgG4 half molecules, which was primarily observed in whole blood andthe cellular fraction of whole blood (FIG. 5 a). Bispecific levels inthe cellular fraction were even higher than in whole blood. This is mostlikely explained by the fact that in the cellular fraction endogenousIgG4, which can also be exchanged with the added chimeric IgG4antibodies, is no longer present. Some bispecific activity was alsoobserved in plasma and serum, but this activity was much lower thanobserved in whole blood and only slightly higher than background level,being 1.7%, which was obtained by incubating the IgG4 mixture inOptimem. No bispecific activity was observed in any of the incubationscontaining IgG1 (FIG. 5 b). Also in the control incubations withoutchimeric antibodies no bispecific activity was observed (FIG. 5 c).Size-exclusion chromatography was performed to exclude the possibilitythat bispecific activity observed in the IgG4 mix was the result of IgGaggregation. For this purpose, a sample (drawn at t=24 h) wasfractionated on a Superdex200 column, after which Fel d 1 binding IgGand Bet v 1-Fel d 1 cross-linking IgG were measured in the fractions.Fel d 1 binding antibodies eluted in one peak with a retention volume of˜12.9 ml, which corresponds to the retention volume of monomeric IgG.The heterologous Bet v 1-Fel d 1 cross-linking activity was detected inthe same fractions indicating that bispecific activity was associatedwith monomeric IgG (data not shown).

Example 26 Evaluation of Blood Cell Mediated IgG4 Fab Arm ExchangeActivity

Chimeric antibodies were mixed and subsequently incubated with threedifferent types of human blood cells (i.e. mononuclear cells (MNC),erythrocytes and platelets) to investigate IgG4 exchange activity.

Whole blood from an anonymous donor was drawn in a heparin containingvacutainer and subsequently centrifuged in Percoll (Pharmacia FineChemicals, Uppsala, Sweden) to isolate MNCs. The isolated MNCs wereresuspended in Optimem serum free culture medium (Invitrogen, Breda, TheNetherlands) before use. Freshly purified erythrocytes and platelets(provided by the Blood Cell Research Department of Sanquin) wereobtained from two different anonymous donors. These cells were alsoresuspended in Optimem after being washed 3 times. In addition,platelets were supplemented with 10 mM glucose.

The exchange of IgG4 half molecules was evaluated and compared to theexchange of IgG1 half molecules. The following antibodies mixtures wereprepared in PBS:

-   -   Bet v 1 specific IgG4 (10 μg) and Fel d 1 specific IgG4 (10 μg)    -   Bet v 1 specific IgG1 (10 μg) and Fel d 1 specific IgG1 (10 μg)

These antibody mixtures were incubated with 1.8×10⁴ MNCs, 4.0×10⁸erythrocytes or 3.5×10⁴ μlatelets in a total volume of 100 μl (finalconcentration for each antibody was 0.1 μg/ml) on a horizontal orbitalshaker (125 rpm) at 37° C. After 48 h the incubation mixtures werecentrifuged for 1 min at 2800 rpm in an Eppendorf centrifuge, afterwhich a sample of 10 μl was drawn in 500 μl PBS-AT (PBS supplementedwith 0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃).Samples were stored, if necessary, at 4° C.

Bispecific activity (i.e. Fel d 1-Bet v 1 cross-linking activity) wasmeasured in the heterologous cross-linking assay. In this assay, asample was incubated for 24 h with 0.5 mg Sepharose-coupled recombinantFel d 1 in a total volume of 300 μl in PBS-IAT (PBS-AT supplemented with1 μg/ml IVIg). Subsequently, the Sepharose was washed with PBS-T andincubated for 24 h with ¹²⁵I-labeled Bet v 1, after which the Sepharosewas washed with PBS-T and the amount of radioactivity bound relative tothe amount of radioactivity added was measured.

In FIG. 6 bispecific activity is shown as percentage bound ¹²⁵I-labeledBet v 1, which was determined in the heterologous cross-linking assay.All three cell types were able to induce bispecific activity. Somebispecific activity was also observed in Optimem serum free medium, butthis activity was much lower than observed in the presence of bloodcells. None of the tested cells was able to exchange IgG1 halfmolecules.

Example 27 Evaluation of IgG4 Fab Arm Exchange by Human and Murine CellLines

Chimeric IgG4 antibodies were mixed and subsequently incubated withthree different cell lines (i.e. Human Embryo Kidney (HEK) cells, murineB cells or hybridomas) to investigate IgG4 exchange activity.

Cell line J558 (provided by the Antigen Presentation Research Group ofSanquin) was chosen as a source of murine B cells. Hybridomas, whichproduce an anti-C1 esterase inhibitor, were obtained from the AutoimmuneResearch Group of Sanquin. Suspension HEK (293F) cells were fromInvitrogen, Breda, The Netherlands. All cells were washed three timeswith PBS, after which the cells were resuspended in PBS.

The exchange of IgG4 half molecules was evaluated by incubating an IgG4antibody mixture consisting of Bet v 1 specific IgG4 (2 μg) and Fel d 1specific IgG4 (2 μg) with the aforementioned cells. The antibody mixturewas incubated with 24×10⁵ HEK cells, 25×10⁵ murine B cells or 21×10⁵hybridomas in a total volume of 50 μl (final concentration for eachantibody was 80 μg/ml) on a horizontal orbital shaker (125 rpm) at 37°C. After 0 h and 24 h the incubation mixtures were centrifuged for 1 minat 2800 rpm in an Eppendorf centrifuge, after which a sample was drawnin PBS-AT (PBS supplemented with 0.3% bovine serum albumin, 0.1%Tween-20 and 0.05% (w/v) NaN₃). Samples were stored, if necessary, at 4°C.

Bispecific activity (i.e. Fel d 1-Bet v 1 cross-linking activity) wasmeasured in the heterologous cross-linking assay. In this assay, sampledilutions were incubated for 24 h with 0.5 mg Sepharose-coupledrecombinant Fel d 1 in a total volume of 300 μl in PBS-IAT (PBS-ATsupplemented with 1 μg/ml IVIg). Subsequently, the Sepharose was washedwith PBS-T and incubated for 24 h with ¹²⁵I-labeled Bet v 1, after whichthe Sepharose was washed with PBS-T and the amount of radioactivitybound relative to the amount of radioactivity added was measured.

In FIG. 7 bispecific activity is shown as percentage bound ¹²⁵I-labeledBet v 1, which was determined in the heterologous cross-linking assay.All three cell types were able to exchange IgG4 half molecules.

Example 28 Evaluation of IgG4 Fab Arm Exchange by Erythrocytes

Chimeric antibodies were mixed and subsequently incubated with humanerythrocytes to investigate the exchange of IgG4 half molecules.Erythrocytes were purified from a single donor and stored at 4° C. inSAGM (Saline Adenine Glucose Mannitol) buffer. Before use the cells werewashed three times with PBS.

In this experiment the exchange of IgG4 half molecules was compared withthe exchange of IgG1. Also, the exchange of IgG4 in the presence ofexcess irrelevant IgG4 was evaluated. The following antibodies mixtureswere prepared in PBS:

-   -   Bet v 1 specific IgG4 (4 μg) and Fel d 1 specific IgG4 (4 μg)    -   Bet v 1 specific IgG1 (4 μg) and Fel d 1 specific IgG1 (4 μg)    -   Bet v 1 specific IgG4 (4 μg), Fel d 1 specific IgG4 (4 μg) and        irrelevant IgG4 specific for antigen X (80 μg)

These mixtures were incubated with erythrocytes in PBS supplemented with0.05% (w/v) NaN₃ in a total volume of 100 μl (final hematocrit wasaround ˜40%) and subsequently incubated on a horizontal orbital shaker(125 rpm) at 37° C. At indicated time points the erythrocytes werecentrifuged for 1 min at 2800 rpm in an Eppendorf centrifuge, afterwhich a sample of 10 μl was drawn in 500 μl PBS-AT (PBS supplementedwith 0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃).Samples were stored at 4° C. before measuring bispecific activity,bivalency and antigen binding. As a control the same mixtures were alsoincubated in PBS without erythrocytes.

Levels of Bet v 1 binding antibodies were measured in the antigenbinding test. To this end, samples were incubated with 0.75 mg ofprotein G Sepharose (Amersham Biosciences, Uppsala, Sweden) in 750 μlPBS-IAT (PBS-AT supplemented with 1 μg/ml IVIg) in the presence of¹²⁵I-labeled Bet v 1 for 24 h. Next, the Sepharose was washed with PBS-T(PBS supplemented with 0.1% Tween-20 and 0.05% (w/v) NaN₃) and theamount of radioactivity bound relative to the amount of radioactivityadded was measured. The concentration of Bet v 1 specific IgG wascalculated using purified Bet v 1 specific antibodies as a standard(range 0-200 ng per test as determined by nephelometer). Bispecificactivity in experiments using Fel d 1 and Bet v 1 specific antibodieswas measured in the Feld1-Betv1 cross-linking assay. In this assay, IgGcontaining sample was incubated for 24 h with Sepharose-coupled catextract (0.5 mg) in a total volume of 300 μl in PBS-AT. Subsequently,the Sepharose was washed with PBS-T and incubated for 24 h with¹²⁵I-labeled Bet v 1, after which the Sepharose was washed with PBS-Tand the amount of radioactivity bound relative to the amount ofradioactivity added was measured. The concentration of bispecific IgG(Feld1-Betvl) was calculated using purified IgG1-Betv1 as a standard(obtained in Bet v 1 binding test using Prot G sepharose).

In FIG. 8 data obtained from the erythrocyte-mediated exchange arepresented. No exchange of IgG1 half molecules was observed in thepresence of erythocytes, whereas about maximum exchange of IgG4 halfmolecules was observed after 72 h (panel A) (note: if equal amounts ofIgG4-Betv1 and IgG4-Feld1 are exchanged, at most 50% of the IgG4-Betv1half-antibodies will be incorporated in the bispecific fraction afterrandom and complete exchange of half molecules). In the presence ofexcess irrelevant IgG4 almost no exchange of IgG4 half molecules wasmeasured, which is in line with the expected exchange of Bet v 1 and Feld 1 specific IgG4 with irrelevant IgG4. Size-exclusion chromatographywas performed to exclude the possibility that bispecific activityobserved in the IgG4 mix was the result of IgG aggregation. For thispurpose, a sample (drawn at t=72h) was fractionated on a Superdex200column, after which Fel d 1 binding IgG and Bet v 1-Fel d 1cross-linking IgG were measured in the fractions. Fel d 1 bindingantibodies eluted in one peak with a retention volume of ˜12.9 ml, whichcorresponds to the retention volume of monomeric IgG. The heterologousBet v 1-Fel d 1 cross-linking activity was detected in the samefractions indicating that bispecific activity was associated withmonomeric IgG (data not shown).

In theory, the exchange of IgG4 half molecules is also associated with adecrease in bivalency. To test this, bivalency in the incubationmixtures was measured. Almost no reduction of Fel d 1 bivalency wasobserved in the IgG1 mix, whereas a reduction of ˜50% was observed inthe IgG4 mix. This reduction is in agreement with the maximal exchangeof two different IgG4 molecules mixed in a 1 to 1 ratio. As expected,the reduction of bivalency in the IgG4 mix with excess irrelevant IgG4was higher (˜80%), which is due to the low probability ofrehybridisation of two homologous half molecules (Bet v 1 or Fel d1specific) in the presence of excess irrelevant IgG4 half molecules. Thestrong reduction in bivalency was not the result of loss of antigenbinding during the incubation, because the antigen binding was onlyslightly (˜10%) decreased after 72 h of incubation (data not shown).

The exchange of IgG in PBS (supplemented with 0.05% (w/v) NaN₃) was alsoevaluated to investigate whether IgG4 half molecules can be exchangedspontaneously. The set-up of this experiment was similar to the exchangein the presence of erythrocytes with the exception that no erythrocyteswere added. No spontaneous exchange of IgG1 or IgG4 half molecules wasobserved during the incubation in PBS at 37° C. as is demonstrated FIG.9A. However, some background was observed in the IgG4 mix, which wasalso present during the incubation with erythrocytes. No decrease ofbivalency was observed during the incubation in PBS (FIG. 9B).

Example 29 Evaluation of IgG4 Fab Arm Exchange by Erythrocyte Lysate

Chimeric IgG4 antibodies were mixed and subsequently incubated withincreasing dilutions of erythrocyte lysate. Erythrocytes were isolatedfrom a healthy donor and stored at 4° C. in SAGM (Saline Adenine GlucoseMannitol) buffer with a hematocrit of 60.7%. To obtain lysate the cellswere washed three times with PBS-Azide (PBS supplemented with 0.05%(w/v) NaN₃) and resuspended in water with a volume that was two foldhigher than the volume of the storage buffer. As a result, undilutederythrocyte lysate was equivalent to a hematocrit of 30%.

The exchange of IgG4 half molecules was evaluated by incubating an IgG4antibody mixture consisting of Bet v 1 specific IgG4 (1 μg) and Fel d 1specific IgG4 (1 μg) with 50 μl of freshly prepared lysate (supplementedwith PBS/Azide to a total volume of 100 μl) at 37° C. Finalconcentration of each antibody was 10 μg/ml. At indicated time points asample was drawn from the incubation mix in PBS-AT (PBS supplementedwith 0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃) tomeasure bispecific activity. Samples were stored, if necessary, at 4° C.

Bispecific activity (i.e. Bet v 1-Fel d 1 cross-linking activity) wasmeasured in the heterologous cross-linking assay. In this assay, sampledilutions were incubated for 24 h with 0.5 mg Sepharose-coupled birchextract in a total volume of 300 μl in PBS-IAT (PBS-AT supplemented with1 μg/ml IVIg). Subsequently, the Sepharose was washed with PBS-T andincubated for 24 h with ¹²⁵I-labeled Fel d 1, after which the Sepharosewas washed with PBS-T and the amount of radioactivity bound relative tothe amount of radioactivity added was measured. The concentration ofbispecific IgG (Bet v 1-Fel d 1) was calculated using the calibrationcurve of the Fel d 1 binding test, which was obtained from purified Feld 1 binding rIgG.

In FIG. 10 generation of bispecific activity in time is shown aspercentage bound ¹²⁵I-labeled Fel d 1, which was determined in theheterologous cross-linking assay. From these data it is evident thatlysate of erythrocytes contains exchange activity. Highest exchange ratewas observed in undiluted lysate, whereas higher dilutions resulted inlower exchange rates. Practically no bispecific activity was observed inthe control incubation in PBS.

Size-exclusion chromatography was performed to exclude the possibilitythat bispecific activity induced by erythrocyte lysate was the result ofIgG aggregation (FIG. 11). For this purpose, an incubation mixture wasprepared consisting of 10 μg Bet v 1 binding IgG4, 10 μg Fel d 1 bindingIgG4 and 50 μl erythrocyte lysate, which was supplemented with PBS/Azideto final volume of 100 μl. This mixture was incubated at 37° C. for 24h, after which 70 μl was fractionated on a Superdex200 column. In thefractions Bet v 1 binding IgG and Fel d 1-Bet v 1 cross-linking IgG weremeasured. Levels of Bet v 1 binding antibodies were measured in theantigen binding test. Samples were incubated with 0.75 mg of protein GSepharose (Amersham Biosciences, Uppsala, Sweden) in 750 μl PBS-IAT (PBSsupplemented with 1 μg/ml IVIg, 0.3% bovine serum albumin, 0.1% Tween-20and 0.05% (w/v) NaN₃) in the presence of ¹²⁵I-labeled Bet v 1 for 24 h.Next, the Sepharose was washed with PBS-T (PBS supplemented with 0.1%Tween-20 and 0.05% (w/v) NaN₃) and the amount of radioactivity boundrelative to the amount of radioactivity added was measured. Theconcentration of Bet v 1 specific IgG was calculated using purified Betv 1 specific antibodies as a standard (range 0-200 ng per test asdetermined by nephelometer). The concentration of bispecific IgG (i.e.Fel d 1-Bet v 1 cross-linking activity) was measured in the heterologouscross-linking assay. In this assay, a sample was incubated for 24 h with0.5 mg Sepharose-coupled cat extract, in which Fel d 1 antigen ispresent, in a total volume of 300 μl in PBS-IAT. Subsequently, theSepharose was washed with PBS-T and incubated for 24 h with ¹²⁵I-labeledBet v 1, after which the Sepharose was washed with PBS-T and the amountof radioactivity bound relative to the amount of radioactivity added wasmeasured. The concentration of bispecific IgG (Fel d 1-Bet v 1) wascalculated using the same calibration curve as used in the Bet v 1binding test, which was obtained from purified Bet v 1 binding rIgG.

Bet v 1 binding antibodies eluted in one peak with a retention volume of˜12.6 ml, which corresponds to the retention volume of monomeric IgG(FIG. 11). The heterologous Fel d 1-Bet v 1 cross-linking activity wasdetected in the same fractions indicating that bispecific activity wasassociated with monomeric IgG.

Example 30 Evaluation of IgG4 Fab Arm Exchange Activity in DialyzedErythrocyte Lysate

Erythrocytes were isolated from a healthy donor and stored at 4° C. inSAGM (Saline Adenine Glucose Mannitol) buffer with a hematocrit of60.7%. To obtain lysate the cells were washed three times with PBS-Azide(PBS supplemented with 0.05% (w/v) NaN₃) and resuspended in water with avolume that was two-fold higher than the volume of the storage buffer.Therefore, undiluted erythrocyte lysate was equivalent to a hematocritof 30%. Part of the lysate was dialyzed against PBS-Azide using adialysis membrane cassette from Pierce (3.5 kD cut-off). Ultrafiltratewas obtained by centrifugation of non-dialyzed lysate in an Amiconfilter (3.5 kD cut-off).

The exchange of IgG4 half molecules was evaluated by incubating an IgG4antibody mixture (Bet v 1 specific IgG4 (0.5 μg) and Fel d 1 specificIgG4 (0.5 μg) with freshly prepared erythrocyte lysate (25 μl) ordialyzed lysate (25 μl) at 37° C. Total volume of each incubation was 50μl resulting in a final concentration of 10 μg/ml for each antibody. Thefollowing supplements were used: reduced glutathione (GSH) from Sigma,Glucose-6-phospate (G-6-P) and NADPH (both from Roche). These compoundswere dissolved in water before use. After 24 h of incubation a samplewas drawn from the incubation mix in PBS-AT (PBS supplemented with 0.3%bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃) to measurebispecific activity. Samples were stored, if necessary, at 4° C.

Bispecific activity (i.e. Fel d 1-Bet v 1 cross-linking activity) wasmeasured in the heterologous cross-linking assay. In this assay, sampledilutions were incubated for 24 h with 0.5 mg Sepharose-coupled catextract in a total volume of 300 μl in PBS-IAT (PBS-AT supplemented with1 μg/ml IVIg). Subsequently, the Sepharose was washed with PBS-T andincubated for 24 h with ¹²⁵I-labeled Bet v 1, after which the Sepharosewas washed with PBS-T and the amount of radioactivity bound relative tothe amount of radioactivity added was measured.

The exchange levels were compared with the bispecific activity generatedby freshly prepared lysate (Table 2).

TABLE 2 Overview of factors that restore bispecific activity in dialyzederythrocyte lists. Exchange activity of dialyzed erythrocyte lysate wascompared with freshly prepared lysate. Dialyzed lysate was supplementedwith 5 □l of ultrafiltrate. Final concentrations of G-6-P, NADPH and GSHwere 5 mM, 0.1 mM and 0.5 mM, respectively. Exchange source SupplementExchange activity Lysate − ++ Dialyzed lysate − − Dialyzed lysateUltrafiltrate + Dialyzed lysate G-6-P, NADPH, GSH ++ Dialyzed lysateG-6-P − Dialyzed lysate NADPH − Dialyzed lysate GSH ++

From these data it is evident that the activity of erythrocyte lysatewas lost after dialysis. Addition of ultrafiltrate restored the exchangefor a large part. This result suggested that during dialysis a component(<3.5 kD) was lost, which is essential for the exchange reaction. Such acomponent is likely to be involved in the redox cycle, because disulfidebridge reduction and oxidation is required for the exchange of IgG4 halfmolecules. Therefore, three “co-factors” (G-6-P, NADPH and GSH) of theredox cycle were added to dialyzed lysate to investigate whether thesecompounds could restore the exchange activity. The exchange activitycould be restored if G-6-P, NADPH and GSH were supplemented together.Incubation of dialyzed lysate in the presence of separate factorsrevealed that the exchange activity was restored by GSH, but not byG-6-P or NADPH.

Example 31 Evaluation of IgG4 Half Molecule Exchange by ReducedGlutathione

Chimeric antibodies were mixed and subsequently incubated with reducedglutathione (GSH) to investigate the exchange of IgG4 half molecules.GSH (Sigma-Aldrich, St. Louis, Mo.) was solved in water before use.

In this experiment the exchange of IgG4 half molecules was evaluated byincubating an IgG4 antibody mixture consisting of Bet v 1 specific IgG4(1 μg) and Fel d 1 specific IgG4 (1 μg) in PBS/Azide containing GSH at37° C. Total incubation volume was 100 μl resulting in a finalconcentration of 10 μg/ml for each antibody. At indicated time points asample was drawn from the incubation mixture in PBS-AT (PBS supplementedwith 0.3% bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃).Samples were stored at 4° C. for measuring of antigen binding andbispecific activity

Levels of Bet v 1 binding antibodies were measured in the antigenbinding test. Samples were incubated with 0.75 mg of protein G Sepharose(Amersham Biosciences, Uppsala, Sweden) in 750 μl PBS-IAT (PBS-ATsupplemented with 1 μg/ml IVIg) in the presence of ¹²⁵I-labeled Bet v 1for 24 h. Next, the Sepharose was washed with PBS-T (PBS supplementedwith 0.1% Tween-20 and 0.05% (w/v) NaN₃) and the amount of radioactivitybound relative to the amount of radioactivity added was measured. Theconcentration of Bet v 1 specific IgG was calculated using purified Betv 1 specific antibodies as a standard (range 0-200 ng per test asdetermined by nephelometer). The concentration of bispecific IgG (i.e.Fel d 1-Bet v 1 cross-linking activity) was measured in the heterologouscross-linking assay. In this assay, a sample was incubated for 24 h with0.5 mg Sepharose-coupled cat extract, in which Fel d 1 antigen ispresent, in a total volume of 300 μl in PBS-IAT. Subsequently, theSepharose was washed with PBS-T and incubated for 24 h with ¹²⁵I-labeledBet v 1, after which the Sepharose was washed with PBS-T and the amountof radioactivity bound relative to the amount of radioactivity added wasmeasured. The concentration of bispecific IgG (Fel d 1-Bet v 1) wascalculated using the same calibration curve as used in the Bet v 1binding test, which was obtained from purified Bet v 1 binding IgG.

In FIG. 12 time courses of GSH mediated exchange of IgG4 half moleculesare presented. From these data it is clear that IgG4 half molecules areexchanged in the presence of GSH. In this experiment optimal exchangewas observed between 0.1 and 1 mM GSH and highest exchange (˜90%) wasreached after 24 h using 0.5 mM GSH.

Size-exclusion chromatography was performed to exclude the possibilitythat bispecific activity observed after GSH mediated exchange of IgG4was the result of IgG aggregation (FIG. 13). For this purpose, a mixtureof Bet v 1 binding IgG4 and Fel d 1 binding IgG4 (10 μg of eachantibody) was incubated with 0.5 mM GSH in PBS/Azide. This mixture(final volume 100 μl) was incubated at 37° C. for 24 h, after which 70μl was fractionated on a Superdex200 column. In the fractions Bet v 1binding IgG and Fel d 1-Bet v 1 cross-linking IgG were measured. Bet v 1binding antibodies eluted in one peak with a retention volume of ˜12.6ml, which corresponds to the retention volume of monomeric IgG. Theheterologous Fel d 1-Bet v 1 cross-linking activity was detected in thesame fractions indicating that bispecific activity was associated withmonomeric IgG. The generation of bispecific IgG4 molecules in thepresence of GSH was found to be temperature dependent, as exchangeoccurred more efficiently at 37° C. than at 4° C. (FIG. 14).

Example 32 Generation of Bispecific IgG in the Presence of Other Agents

IgG1-Betv1 and IgG1-Feld1 or IgG4-Betv1 and IgG4-Feld1 were mixed at afinal concentration of 10 μg/ml for antibody and incubated with reducingagents in a total volume of 50 μl. Apart from GSH the following agentswere tested (final concentration in incubation mixture): L-cysteine wasfrom Sigma (100 μM), dithiothreitol (DTT) was from Biorad (50 μM),β-mercapto-ethanol (BME) was from Biorad (100 μM) and oxidizedglutathione (GSSG, note that of the panel of agents this agent is notreducing, while all others are) was from Sigma (100 μM). The mixtureswere incubated at 37° C. for 24 h and samples were drawn in PBS/AT, inwhich the (bi)specific IgG concentrations were measured. FIG. 15 showsthat the addition of GSH or other reducing agents (but not of GSSG) to amixture of purified IgG4-Betv1 and IgG4-Feld1 was sufficient to induceFab arm exchange and the generation of bispecific IgG4. In contrast, nobispecific reactivity was induced in the control IgG1 mixture.

Example 33 Exchange of Fully Human IgG4 Antibodies Using GSH

IgG1-CD20, IgG4-CD20, IgG1-EGFr and IgG4-EGFr were mixed and incubatedwith GSH in a total volume of 1 ml. Final concentration of each antibodywas 50 μg/ml; the final concentration of GSH was 0.5 mM. The mixtureswere incubated at 37° C. for 24 h and samples were drawn in PBS-AT, inwhich the (bi)specific IgG concentrations were measured.

Bispecific activity was determined using a sandwich ELISA. For thisassay an ELISA plate (Greiner bio-one, Frickenhausen, Germany) wascoated overnight with 1 μg/ml (100 μl/well) of recombinant extracellulardomain of EGFR in PBS at 4° C. The plate was washed 3 times withPBS/0.05 Tween 20 (PBT). Samples were diluted in PBT/0.2% BSA (PBTB) andtransferred to the ELISA plate (100 μl/well). After incubation on aplate shaker (300 rpm) for 90 minutes at room temperature (RT), sampleswere discarded and the plate was washed 3 times with PBT. Next, 100 μlof the mouse anti-idiotypic monoclonal antibody 2F2 SAB1.1 (directedagainst the anti-CD20 antibody 7D8; Genmab) at 2 μg/ml in PBTB was addedand incubated at RT for 90 minutes at a plate shaker (300 rpm). Theanti-idiotypic antibody was discarded and the plate was washed 3 timeswith PBT, followed by the addition of 100 μl/well of a HRP conjugatedgoat anti-mouse IgG (Jackson ImmunoResearch Laboratories, Westgrove,Pa., USA) at a 1000× dilution in PBTB and incubation at RT for 90minutes at a plate shaker (300 rpm). The detection antibody wasdiscarded and the plate was washed 3 times with PBT. A 50 mg ABTS tablet(Roche Diagnostics GmbH, Mannheim, Germany) was dissolved in ABTS buffer(Roche) and added to the ELISA plate (100 μl/well). The ELISA plate wasincubated for 30 min (or longer if desired) at RT on a plate shaker (300rpm) covered with aluminum foil and the reaction was stopped with 100 μloxalic acid (Riedel de Haen Seelze, Germany) per well. The ELISA platewas left at RT for 10 minutes before reading absorbance at 405 nm in anELISA plate reader.

FIG. 16A shows that bispecific anti-EGFR/CD20 antibodies formed in timeupon incubation of the mixture of IgG4-EGFr and IgG4-CD20 in thepresence, but not in the absence, of GSH. Fab arm exchange did not occurin a mixture of IgG1 antibodies, neither in the presence or absence ofGSH.

To explore the dynamic range of GSH mediated exchange of IgG4 halfmolecules, a full concentration curve of GSH (0.5-1,000 μM) was used toanalyze exchange. IgG4-CD20 and IgG4-EGFr were mixed and incubated withGSH in a total volume of 1 ml. Final concentration of each antibody was50 μg/ml; the final concentration of GSH were as indicated in FIG. 16B.The mixtures were incubated at 37° C. for 24 h and samples were drawn inPBS-AT, in which the (bi)specific IgG concentrations were measured.

FIG. 16B shows a clear GSH-dose dependence of IgG4 half moleculeexchange. To explore how reaction components influence the GSH-mediatedIgG4 half molecule exchange, exchange was tested in PBS and serum- andprotein free, chemically defined medium (FreeStyle 293 expressionmedium, GIBCO/Invitrogen Corporation). It was found that in this tissueculture medium, GSH-mediated exchange occurs at lower GSH-concentrations(FIG. 16C). It was also found that there is an optimum in GSH-mediatedIgG4 half molecule exchange, as incubation with 5 mM GSH clearlyresulted in lower exchange that with 0.5 mM (FIG. 16D).

A mixture of IgG4-EGFr and IgG4-CD20 was incubated for 24 h in theabsence or presence of GSH and evaluated by mass spectrometry (ESI-TOFMS). Fifty μl samples containing 200 μg/ml of each antibody weredeglycosylated overnight with 1 μl N-glycosidase F (Roche Diagnostics NLBV, Almere, The Netherlands). Samples were desalted on an Acquity UPLC™(Waters, Milford, USA) with a BEH C8, 1.7 μm, 2.1×50 mm column at 60° C.Five μl was injected and eluted with a gradient from 5% to 95% eluent B.Eluent A was MilliQ water (Millipore Synthesis A10 apparatus) and eluentB was LC-MS grade acetonitrile (Biosolve, Valkenswaard, TheNetherlands). Both eluents contained 0.05% formic acid as organicmodifier (Fluka Riedel-de Haen, Buchs, Germany). Time-of-flightelectrospray ionization mass spectra were recorded on-line on amicrOTOF™ mass spectrometer (Bruker, Bremen, Germany) operating in thepositive ion mode. In each analysis, a 500-5000 m/z scale was internallycalibrated with ES tuning mix (Agilent Technologies, Santa Clara, USA).Mass spectra were deconvoluted by using the Maximum Entropy algorithm,which is provided with DataAnalysis™ software v. 3.3 (Bruker).

FIG. 16E shows that the molecular weights of IgG4-CD20 (145.5 kD) andIgG4-EGFR (145.9 kD) remained unchanged in the absence of GSH. In thepresence of GSH (FIG. 16F), however, a new peak with a masscorresponding to a Fab arm exchanged molecule appeared (145.7 kD). Thenovel mass corresponded to the expected mass of the bispecificanti-EGFR/CD20 antibody. Moreover, from the peak heights of the MSspectra it could be estimated that the bispecific antibody represented50% of the total antibody mass in the mixture indicating a randomexchange which reached equilibrium within 24 hours.

Example 34 Rhesus Monkey IVIg Participates in Fab Arm Exchange ofRecombinant Human IgG4 Antibodies

Mixtures of two recombinant human IgG4 antibodies (IgG4-CD20 andIgG4-EGFr, as described above) were incubated with GSH for 24 h at 37°C., in the presence or absence of rhesus monkey or human IVIg. Theformation of bispecific antibodies through Fab arm exchange was measuredin a sandwich ELISA as described above.

FIG. 17 shows that monkey polyclonal IVIg compares to human polyclonalIVIg in its ability to inhibit the exchange of Fab arms of therecombinant antibodies in vitro in the presence of reduced glutathione.This means that a component of rhesus IVIg, rhesus immunoglobulin,participates in Fab arm exchange. Rhesus immunoglobulin, presumablyrhesus IgG4, can exchange Fab arm with recombinant human IgG4.

Example 35 Fab Arm Exchange of Hinge Region or CH3 Domain Mutants

Three IgG1 mutants were made: an IgG1 with an IgG4 core-hinge(IgG1-CPSC) and two CH3 domain swap mutants (IgG1-CH3(IgG4) andIgG1-CPSC-CH3(IgG4).

Site directed mutagenesis was used to introduce a P228S mutation in thehinge of IgG1 using pEE-G1-wt a Bet v 1 as a template. Mutagenicprimers, forward and reverse, were designed with Vector NTI Advance 10:

P228S Mut primer-F: SEQ ID NO: 19: cttgtgacaa aactcacacc tgcccatcgtgcccaggtaa gccag P228S Mut primer-R: SEQ ID NO: 20: ctggcttacctgggcacgat gggcaggtgt gagttttgtc acaag

Quickchange site-directed mutagenesis kit (Stratagene) was used tocreate the pEE-G1-CPSC mutant. The polymerase chain reaction (PCR) mixconsisted of 5 μl pEE-G1 a Betv1 DNA template (˜35 ng), 1.5 μl mutagenicprimer-forward (˜150 ng), 1.5 μl mutagenic primer-reverse (˜450 ng), 1μl dNTP mix, 5 μl reaction buffer (10×), 36 μl H₂O and finally 1 μl PfuTurbo DNA polymerase. Then the mix was applied to the PCR: 30″ 95° C.,30″ 95° C. (denaturating), 1′ 55° C. (annealing) and 17 minutes 68° C.(elongating). This cycle was repeated 20 times.

DNA digesting and ligation was used to create CH3 domain swap mutantconstructs IgG1-CH3(IgG4) and IgG1-CPSC-CH3(IgG4). Digestion reactionsto obtain CH3 domains and vectors without CH3 domains were as follows:˜1500 ng DNA (pEE-G1-betv1, pEE-G1-CPSC and pEE-G4-betv1), 2 μl BSA, 2μl Neb3 buffer, 1 μl SalI and H₂O added to a volume of 20 μl. Incubationat 37° C. for 30′. DNA was purified and eluted with 30 μl H₂O before 1μl SanDI and 3 μl universal buffer was added and incubated at 37° C. for30′. Fragments were subjected to gel electrophoresis on 1% agarose gelswith ethidium bromide. Fragments were cut from the gel under ultravioletlight and dissolved using a DNA purification kit (Amersham). ThepEE-G4-wt SalI/SanDI (which contained IgG4 CH3 domain) fragment wasligated into pEE-G1-wt and pEE-G1-CPSC using following procedure: 1 μltemplate DNA (SalI/SanDI digested pEE-G1-wt and pEE-G1-CPSC), 5 μlSalI/SanDI insert, 4 μl Ligate-it buffer, 9 μl H₂O and 1 μl ligase in atotal volume of 20 μl. Ligation was stopped after 5′.

DNA digestion (using ApaI and HindIII) and ligation was used to replacethe VH domain of the bet v 1 mutant antibodies with that ofpEE-G4-a-feld1 wt, following a similar procedure as above.

Also, one IgG4 mutant was made: IgG4-S228Pnew. In this mutant, the hingeis stabilized by replacing serine at position 228 for a proline (IgG1core hinge). Site-directed mutagenesis was performed using theQuickChange II XL Site-Directed Mutagenesis Kit (Stratagene, Amsterdam,The Netherlands) according to the manufacturer's instructions. Thismethod included the introduction of a silent extra XmaI site to screenfor successful mutagenesis. Briefly, 5 μl 10× reaction buffer, 1 μloligonucleotide S228Pfcorrect (100 pmol/μl), 1 μl oligonucleotideS228Prcorrect (100 pmol/μl), 1 μl dNTP mix, 3 μl Quicksolution, 1 μlplasmid pTomG42F8HG (50 ng/μl) (described in PCT application entitled“Recombinant monovalent antibodies and methods for production thereof”,filed on 28 Nov. 2006 (RO/DK (Genmab)) and 1 μl PfuUltra HF DNApolymerase were mixed in a total volume of 50 μl and amplified with aTGradient Thermocycler 96 (Whatman Biometra, Goettingen, Germany;product #050-801) using an 18-cycle program: denaturing at 95° C. for 1min; 18 cycles of 95° C. for 50 sec, 60° C. for 50 sec, and 68° C. for10 min. PCR mixtures were stored at 4° C. until further processing.Next, PCR mixtures were incubated with 1 μl Dpnl for 60 min at 37° C. todigest the pTomG42F8HG vector and stored at 4° C. until furtherprocessing. The reaction mixture was precipitated with 5 μl 3 M NaAc and125 μl Ethanol, incubated for 20 minutes at −20° C. and spun down for 20minutes at 4° C. at 14000×g. The DNA pellet was washed with 70% ethanol,dried and dissolved in 4 μl water. The total 4 μl reaction volume wastransformed in One Shot DNH5α T1^(R) competent E. coli cells(Invitrogen, Breda, The Netherlands) according to the manufacturer'sinstructions (Invitrogen). Next, cells were plated on Luria-Bertani (LB)agar plates containing 50 μg/ml ampicillin. Plates were incubated for16-18 hours at 37° C. until bacterial colonies became evident.

After screening by colony PCR and XmaI (mutagenesis will result in theloss of a XmaI site) digestion, plasmid was isolated from the bacteriaand the mutation was confirmed by DNA sequencing. To check if nounwanted extra mutations were introduced the whole HC coding region wassequenced and did not contain any additional mutations. The finalconstruct was named pTomG42F8S228PNew.

Name Oligonucleotide Sequence S228PfcorrectCCCCCATGCCCACCATGCCCAGGTAAGCCAACCCAGGCCTCGC (SEQ ID NO: 21)S228Prcorrect GCGAGGCCTGGGTTGGCTTACCTGGGCATGGTGGGCATGGGGG (SEQ ID NO:22)

Recombinant antibodies from these constructs were transiently expressedin HEK 293 cells in 3 ml, 6-wells plates (NUNC) or in 125 ml erlenmeyers(Corning) with 293 Fectin (Invitrogen) as transfection reagent.

The following mixtures of unpurified antibodies (FreeStyle 293expression medium, GIBCO/Invitrogen Corporation) were incubated with 0.1mM GSH at 37° C. for 24 h and samples were drawn in PBS-AT, in which the(bi)specific IgG concentrations were measured as described in previousexamples:

-   -   IgG4 anti-feld1 wt with IgG4 anti-betv1 wt    -   IgG1 anti-feld1 wt with IgG4 anti-betv1 wt    -   IgG1 anti-feld1 CPSC with IgG1 atni-betv1 CPSC (indicated as        IgG1 CPSC-IgG1 CPSC below)    -   IgG1 anti-feld1 CPSC with IgG1 anti-betv1 CH3(IgG4) (IgG1        CPSC-IgG1 CH3(IgG4))    -   IgG1 anti-feld1 CPSC with IgG1 anti-betv1 CPSC/CH3(IgG4) (IgG1        CPSC-IgG1 CPSC/CH3(IgG4))    -   IgG1 anti-feld1 CH3(IgG4) with IgG1 anti-betv1 CH3(IgG4) (IgG1        CH3(IgG4)-IgG1 CH3(IgG4))    -   IgG1 anti-feld1 CH3(IgG4) with IgG1 anti-betv1 CPSC/CH3(IgG4)        (IgG1 CH3(IgG4)-IgG1 CPSC/CH3(IgG4))    -   IgG1 anti-feld1 CPSC/CH3(IgG4) with anti-betv1 IgG1        CPSC/CH3(IgG4) (IgG1 CPSC/CH3(IgG4)-IgG1 CPSC/CH3(IgG4))    -   IgG1 anti-feld1 CPSC/CH3(IgG4) with IgG4 a-ntibetv1 wt (IgG1        CPSC/CH3(IgG4)-IgG4 wt)    -   IgG4 anti-ben S228Pnew with IgG4 wt

The results showed that under these in vitro conditions (0.1 mM GSH),half molecule exchange occurs when one of the antibodies contains theCPSC hinge and both antibodies contain an IgG4-like CH3. Also, halfmolecule exchange occurs between an IgG4 molecule containing an IgG1hinge and IgG4 wt molecules:

IgG1 IgG1 IgG1 CPSC/ IgG1 wt IgG4 wt CH3(IgG4) CPSC CH3(IgG4) IgG1 wt −− IgG4 wt − + + − + IgG1 + − − ± CH3(IgG4) IgG1 CPSC − − − − IgG1 + ±− + CPSC/ CH3(IgG4) IgG4 − + S228Pnew − = no exchange + = exchangeoccurs ± = limited exchange (~5%) Blank square = not tested

The effect of GSH concentration on the half molecule exchange from thedifferent mutants was tested using 0, 0.1, 1 and 10 mM GSH. Exchange wastested using the following mixtures:

-   -   IgG4 a-feld1 wt with IgG4 a-betv1 wt    -   IgG1 a-feld1 wt with IgG4 a-betv1 wt    -   IgG1 a-feld1 CPSC with IgG1 a-betv1 CPSC    -   IgG1 a-feld1 CH3(IgG4) with IgG1 a-betv1 CH3(IgG4)    -   IgG1 a-feld1 CPSC/CH3(IgG4) with a-betv1 IgG1 CPSC/CH3(IgG4))

For GSH concentrations up to 1 mM, the results (FIG. 18) confirmed thosedescribed above. At 10 mM GSH, half molecule exchange was also seen inthe reaction containing IgG1 a-feld1 CH3(IgG4) and IgG1 a-betv1CH3(IgG4).

Size-exclusion chromatography was performed to exclude the possibilitythat bispecific activity observed after GSH mediated exchange of theappropriate IgG1 mutants was the result of IgG aggregation as describedin previous examples. The heterologous Fel d 1-Bet v 1 cross-linkingactivity was detected in the fractions corresponding to the retentionvolume of monomeric IgG.

Example 36 Generation of IgG1 and IgG4 Antibodies with Hinge Regionand/or CH3 Domain Mutations

Five IgG1 mutants were made: an IgG1 with an IgG4 core-hinge(IgG1-P228S), two CH3 domain swap mutants (IgG1-CH3(γ4) andIgG1-P228S-CH3(γ4)), one CH3 point mutant in which lysine present atposition 409 of IgG1 (within the CH3 domain) is replaced for arginine(IgG1-K409R), and one IgG1 with an IgG4 core hinge and K409R mutation(IgG1-P228S-K409R) (FIG. 19). These mutants were made with either Bet v1 or Fel d 1 specificity.

Two IgG4 mutants were made: one CH3 point mutant in which argininepresent at position 409 of IgG4 (within the CH3 domain) is replaced forlysine (IgG4-R409K), and one CH3 swap mutant (IgG4-CH3(γ1)) (FIG. 19).These mutants were also made with either Bet v 1 or Fel d 1 specificity.

Site directed mutagenesis was used to introduce a P228S mutation in thehinge of IgG1 using pEE-G1-wt a Bet v 1 as a template. Mutagenicprimers, forward and reverse, were designed with Vector NTI Advance 10:

P228S Mut primer-F: SEQ ID NO: 23: cttgtgacaa aactcacacc tgcccatcgtgcccaggtaa gccag P228S Mut primer-R: SEQ ID NO: 24: ctggcttacctgggcacgat gggcaggtgt gagttttgtc acaag

Quickchange site-directed mutagenesis kit (Stratagene) was used tocreate the pEE-G1-CPSC mutant. The polymerase chain reaction (PCR) mixconsisted of 5 μl pEE-G1 a Betv1 DNA template (˜35 ng), 1.5 μl mutagenicprimer-forward (˜150 ng), 1.5 μl mutagenic primer-reverse (˜150 ng), 1μl dNTP mix, 5 μl reaction buffer (10×), 36 μl H₂O and finally 1 μl PfuTurbo DNA polymerase. Then the mix was applied to the PCR: 30″ 95° C.,30″ 95° C. (denaturating), 1′ 55° C. (annealing) and 17 minutes 68° C.(elongating). This cycle was repeated 20 times.

DNA digesting and ligation was used to create CH3 domain swap mutantconstructs IgG1-CH3(γ4) and IgG1-P228S-CH3(γ4). Digestion reactions toobtain CH3 domains and vectors without CH3 domains were as follows:˜1500 ng DNA (pEE-G1-betv1, pEE-G1-CPSC and pEE-G4-betv1), 2 μl BSA, 2μl Neb3 buffer, 1 μl Sall and H₂O added to a volume of 20 μl. Incubationat 37° C. for 30′. DNA was purified and eluted with 30 μl H₂O before 1μl SanDI and 3 μl universal buffer was added and incubated at 37° C. for30′. Fragments were subjected to gel electrophoresis on 1% agarose gelswith ethidium bromide. Fragments were cut from the gel under ultravioletlight and dissolved using a DNA purification kit (Amersham). ThepEE-G4-wt SalI/SanDI (which contained IgG4 CH3 domain) fragment wasligated into pEE-G1-wt and pEE-G1-CPSC using following procedure: 1 μltemplate DNA (SalI/SanDI digested pEE-G1-wt and pEE-G1-CPSC), 5 μlSall/SanDI insert, 4 μl Ligate-it buffer, 9 μl H₂O and 1 μl ligase in atotal volume of 20 μl. Ligation was stopped after 5′.

DNA digestion (using Apal and HindIll) and ligation was used to replacethe VH domain of the bet v 1 mutant antibodies with that ofpEE-G4-a-feld1 wt, following a similar procedure as above.

Site-directed mutagenesis was used to introduce point mutations (K409Ror R409K) into the pEE-γ4 wt, pEE-γ1 and PEE-γ1-P228S constructs.Mutagenic primers, forward and reverse, were designed with Vector NTIAdvance 10:

G1-K409R Mut-F: SEQ ID NO: 25

G1-K409R Mut-R: SEQ ID NO: 26

G4-R409K Mut-F: SEQ ID NO: 27

G4-R409K Mut-R: SEQ ID NO: 28

Restric- Mutagenic Primer Sequence 5′-3′ Mutation tion site G1-K409RMut-F CCTTCTTCCTCTATAGCAGGCTCACCGTAGACAAGAGCAGGTG Lys > Arg AccI GCG1-K409R Mut-R GCCACCTGCTCTTGTCTACGGTGAGCCTGCTATAGAGGAAGAA Lys > ArgAccI GG G4-R409K Mut-F GGCTCCTTCTTCCTCTACAGCAAGCTAACCGTAGACAAGAGCAArg > Lys AccI GG G4-R409K Mut-RCCTGCTCTTGTCTACGGTTAGCTTGCTGTAGAGGAAGAAGGAG Arg > Lys AccI CC

Site-directed mutagenesis was performed using the QuickChange II XLSite-Directed Mutagenesis Kit (Stratagene, Amsterdam, The Netherlands)according to the manufacturer's instructions, with changes as indicatedbelow to increase mutagenic efficiency. This method included theintroduction of a silent extra AccI site to screen for successfulmutagenesis. First, a prePCR mix was used containing 3 μl 10× pfureaction buffer, 1 μl dNTP mix (10 mM), 275 ng forward or reverseprimer, 50 ng template DNA and 0.75 μl Pfu turbo hotstart polymerase. AprePCR was run using a GeneAmp PCR system 9700 (Applied Biosystems):initial denaturation at 94° C. for 5 min; 4 cycles of 94° C. for 30 sec,50° C. for 1 min and 68° C. for 14 min. 25 μl of forward primercontaining prePCR mix was added to 25 μl of reverse primer containingprePCR mix. 0.5 μl Pfu turbo hotstart was added and amplification wasperformed: denaturing at 94° C. for 1 min; 14 cycles of 94° C. for 1min, 50° C. for 1 min and 68° C. for 8 min; 12 cycles of 94° C. for 30sec, 55° C. for 1 min and 68° C. for 8 min.

PCR mixtures were stored at 4° C. until further processing. Next, PCRmixtures were incubated with 1 μl DpnI for 60 min at 37° C. and storedat 4° C. until further processing. 2 μl of the digested PCR products wastransformed in One Shot DNH5α T1^(R) competent E. coli cells(Invitrogen, Breda, The Netherlands) according to the manufacturer'sinstructions (Invitrogen). Next, cells were plated on Luria-Bertani (LB)agar plates containing 50 μg/ml ampicillin. Plates were incubated for16-18 hours at 37° C. until bacterial colonies became evident.

After screening by colony PCR and AccI digestion to check for successfulmutagenesis, plasmid was isolated from the bacteria and the mutation wasconfirmed by DNA sequencing. To check if no unwanted extra mutationswere introduced the whole HC coding region was sequenced and did notcontain any additional mutations.

Sequence Primer sequence (5′-3′) CH1-Betv1-F: TCTCCTCAGCCAGCACCAAG SEQID NO: 29 CH1-Feld1-F: GTTTGTCTGCAGCCAGCACCAAG SEQ ID NO: 30 CH2-F:CATCTCCAAAGCCAAAGGTGGGACC SEQ ID NO: 31 CH2-R: GGTCCCACCTTTGGCTTTGGAGATGSEQ ID NO: 32 CH3-F: CGACGGCTCCTTCTTCCTCTACAG SEQ ID NO: 33 CH3-R:CTGTAGAGGAAGAAGGAGCCGTCG SEQ ID NO: 34 Intron2-F:CAAGAGCCATATCCGGGAGGACC SEQ ID NO: 35 Intron2-R: GGTCCTCCCGGATATGGCTCTTGSEQ ID NO: 36 pEE-F: GTCAGAGGTAACTCCCGTTG SEQ ID NO: 37 pEE-R:GTTGTGGTTTGTCCAAACTC SEQ ID NO: 38

Recombinant antibodies from these constructs were transiently expressedin HEK 293 cells in 3 ml, 6-wells plates (NUNC) or in 125 or 250erlenmeyers (Corning) with 293 Fectin (Invitrogen) as transfectionreagent.

Example 37 Fab Arm Exchange of IgG1 and IgG4 Hinge Region or CH3 DomainMutants

Antibodies were mixed and subsequently incubated with reducedglutathione (GSH) to investigate the exchange of half molecules. GSH(Sigma-Aldrich, St. Louis, Mo.) was dissolved in water before use.

The exchange of half molecules was evaluated by incubating an antibodymixture consisting of Bet v 1 specific antibody (200 ng) and Fel d 1specific antibody (200 ng) in PBS/Azide containing GSH (1 or 10 mM) at37° C. Total incubation volume was 50 μl. After 24 hours samples weredrawn from the incubation mixture in PBS-AT (PBS supplemented with 0.3%bovine serum albumin, 0.1% Tween-20 and 0.05% (w/v) NaN₃). For samplescontaining 10 mM GSH an equimolar amount of iodine-acetamide, a stronglyalkylating agent that inhibits the GSH activity, was added. Samples werestored at 4° C. for measuring of antigen binding and bispecific activity

Levels of Bet v 1 binding antibodies were measured in the antigenbinding test. Samples were incubated with 0.75 mg of protein G Sepharose(Amersham Biosciences, Uppsala, Sweden) in 750 μl PBS-IAT (PBS-ATsupplemented with 1 μg/ml IVIg) in the presence of ¹²⁵I-labeled Bet v 1for 24 h. Next, the Sepharose was washed with PBS-T (PBS supplementedwith 0.1% Tween-20 and 0.05% (w/v) NaN₃) and the amount of radioactivitybound relative to the amount of radioactivity added was measured. Theconcentration of Bet v 1 specific IgG was calculated using purified Betv 1 specific antibodies as a standard (range 0-200 ng per test asdetermined by nephelometer).

The concentration of bispecific IgG (i.e. Fel d 1-Bet v 1 cross-linkingactivity) was measured in the heterologous cross-linking assay. In thisassay, a sample was incubated for 24 h with 0.5 mg Sepharose-coupled catextract, in which Fel d 1 antigen is present, in a total volume of 300μl in PBS-IAT. Subsequently, the Sepharose was washed with PBS-T andincubated for 24 h with ¹²⁵I-labeled Bet v 1, after which the Sepharosewas washed with PBS-T and the amount of radioactivity bound relative tothe amount of radioactivity added was measured. The concentration ofbispecific IgG (Fel d 1-Bet v 1) was calculated using the samecalibration curve as used in the Bet v 1 binding test, which wasobtained from purified Bet v 1 binding IgG. Tests were performed usingantibody-containing supernatants in FreeStyle 293 expression medium,GIBCO/Invitrogen Corporation.

The following antibody mixtures were used:

-   -   Betv1-IgG1 wt with Feld1-IgG1 wt (indicated as IgG1 wt in FIG.        20)    -   Betv1-IgG1 P228S with Feld1-IgG1-P228S (IgG1-P228S in FIG. 20)    -   Betv1-IgG4-CH3(γ1) with Feld1-IgG4-CH3(γ1) (IgG4-CH3(γ1) in FIG.        20)    -   Betv1-IgG4-R409K with Feld1-IgG4-R409K (IgG4-R409K in FIG. 20)    -   Betv1-IgG1-CH3(γ4) with Feld1-IgG1-CH3(γ4) (IgG1-CH3(γ4) in FIG.        20)    -   Betv1-IgG1-K409R with Feld1-IgG1-K409R (IgG1-K409R in FIG. 20)    -   Betv1-IgG4 wt with Feld1-IgG4 wt (IgG4 wt in FIG. 20)    -   Betv1-IgG1-P228S-CH3(γ4) with Feld1-IgG1-P228S-CH3(γ4)        (IgG1-P228S-CH3(γ4) in FIG. 20)    -   Betv1-IgG1-P228S-K409R with Feld1-IgG1-P228S-K409R        (IgG1-P228S-K409R in FIG. 20)

The results (FIG. 20) showed that at 1 mM GSH, half molecule exchangeoccurs between IgG4 wt, IgG1-P228S-K409R or IgG1-P228S-CH3(γ4)antibodies. Under these conditions, IgG1 wt, IgG1-P228S, IgG4-CH3(γ1),IgG4-R409K, IgG1-CH3(γ4) or IgG1-K409R antibodies showed no or onlyminimal exchange of half molecules. At 10 mM GSH, half molecule exchangewas also seen in the reactions containing IgG1-CH3(γ4) or IgG1-K409Rantibodies.

Example 38 Additional CH3 Mutations to Stabilize Dimerization ofHingeless IgG4 Antibody Molecules in the Absence of IVIG

Hingeless IgG4 antibody (HG) molecules form dimers by low affinitynon-covalent interactions. WO/2007/059782 describes that thisdimerization process can be inhibited by using HG IgG4 molecules in thepresence of an excess of irrelevant antibodies. WO/2007/059782 describesa hingeless IgG4 anti-EGFR antibody 2F8-HG.

Construction of pHG-2F8: A vector for the expression of the heavy chainof 2F8-HG: The heavy chain cDNA encoding region of 2F8-HG was codonoptimized and cloned in the pEE6.4 vector (Lonza Biologics, Slough, UK).The resulting vector was named pHG-2F8.

Construction of pKappa2F8: A vector for the production of the lightchain of 2F8 antibodies: The VL region encoding antibody 2F8 was codonoptimized and cloned in the pKappa2F2 vector (a vector encoding thecodon optimized cDNA region of antibody 2F2 (described in WO2004035607)in vector pEE12.4 (Lonza)), replacing the 2F2 VL region with the 2F8 VLregion. The resulting vector was named pKappa-2F8.

Hingeless IgG4 anti-EGFR antibody 2F8-HG has been described inWO/2007/059782. The additional mutations given in the Table below wereintroduced into the CH3 region of hingeless IgG4 antibody 2F8-HG bysite-directed mutagenesis.

KABAT indicates amino acid numbering according to Kabat (Kabat et al.,Sequences of Proteins of Immunological Interest, 5th Ed. Public HealthService, National Institutes of Health, Bethesda, Md. (1991)

-   EU index indicates amino acid numbering according to EU index as    outlined in Kabat et al., Sequences of Proteins of Immunological    Interest, 5th Ed. Public Health Service, National Institutes of    Health, Bethesda, Md. (1991))-   SEQ ID NO:39, 40, 41 indicates amino acid numbering as indicated in    SEQ ID NO:39, 40 and 41 of this document.-   See also FIG. 22 for comparison of numbering methods.

Numbering of CH3 mutations KABAT EU index G4 SEQ ID NO: 39, 40, 41 436F405A F285A 436 F405L F285L 440 R409A R289A 440 R409K R289K

To make the constructs for the expression of the CH3 mutants, themutations were introduced into pHG2F8 using site-directed mutagenesis,using the following primers:

Name nt Sequence HGF417Af 48CCAGTGCTGGACAGCGACGGAAGCTTCGCCCTGTACAGCAGGCTGACC (SEQ ID NO: 42)HGF417Ar 48 GGTCAGCCTGCTGTACAGGGCGAAGCTTCCGTCGCTGTCCAGCACTGG (SEQ ID NO:43) HGF417Lf 51 CCAGTGCTGGACAGCGACGGATCCTTCTTACTGTACAGCAGGCTGACCGTG (SEQID NO: 44) HGF417Lr 51CACGGTCAGCCTGCTGTACAGTAAGAAGGATCCGTCGCTGTCCAGCACTGG (SEQ ID NO: 45)HGR421Af 46 GCTCCTTCTTCCTGTACAGCGCGTTAACCGTGGACAAGTCCAGGTG (SEQ ID NO:46) HGR421Ar 46 CACCTGGACTTGTCCACGGTTAACGCGCTGTACAGGAAGAAGGAGC (SEQ IDNO: 47) HGR421Kf 45 CTCCTTCTTCCTGTACAGCAAGCTTACCGTGGACAAGTCCAGGTG (SEQID NO: 48) HGR421Kr 45 CACCTGGACTTGTCCACGGTAAGCTTGCTGTACAGGAAGAAGGAG(SEQ ID NO: 49)

The constructs were expressed transiently in HEK-293F cells bycotransfecting the heavy-chain- and light-chain-encoding plasmids andbinding to purified EGFr was determined in the absence and presence of200 μg/ml polyclonal human IgG (Intravenous Immunoglobulin, IVIG,Sanquin Netherlands).

Binding affinities were determined using an ELISA in which purified EGFr(Sigma, St Louis, Mo.) was coated to 96-well Microlon ELISA plates(Greiner, Germany), 50 ng/well. Plates were blocked with PBSsupplemented with 0.05% Tween 20 and 2% chicken serum. Subsequently,samples, serially diluted in a buffer containing 100 μg/ml polyclonalhuman IgG (Intravenous Immunoglobulin, IVIG, Sanquin Netherlands) wereadded and incubated for 1 h at room temperature (RT). Plates weresubsequently incubated with peroxidase-conjugated rabbit-anti-humankappa light chain (DAKO, Glostrup, Denmark) as detecting antibody anddeveloped with 2,2′-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid)(ABTS; Roche, Mannheim, Germany). Absorbance was measured in amicroplate reader (Biotek, Winooski, Vt.) at 405 nm.

FIG. 21 shows that the binding curve of 2F8-HG in the presence of IVIG(thick dotted line with closed boxes) clearly right-shifts with respectto the binding curve of 2F8-HG without IVIG (thick closed line with openboxes). This difference in avidity for the EGFr coat is consistent withthe idea that, in the presence of IVIG, 2F8-HG binds monovalently. Thebinding curves of the tested mutations, 2F8-HG-F405L, 2F8-HG-F405A,2F8-HG-R409A and 2F8-HG-R409KA, become insensitive to the addition ofIVIG and were super-imposable on the bivalent binding curve of 2F8-HG inthe absence of IVIG. These differences in avidity for the EGFr coat areconsistent with the idea that the 2F8-HG-F405L, 2F8-HG-F405A,2F8-HG-R409A and 2F8-HG-R409K mutations stabilize dimerization of the HGmolecules.

Example 39 Additional CH3 Domain Mutations to Stabilize Dimerization ofHuman IgG4 Antibodies

Mutations as given in the Table below were introduced into the CH3domains of IgG4-CD20 and IgG4-EGFr by site-directed mutagenesis.

KABAT indicates amino acid numbering according to Kabat (Kabat et al.,Sequences of Proteins of Immunological Interest, 5th Ed. Public HealthService, National Institutes of Health, Bethesda, Md. (1991)

-   EU index indicates amino acid numbering according to EU index as    outlined in Kabat et al., Sequences of Proteins of Immunological    Interest, 5th Ed. Public Health Service, National Institutes of    Health, Bethesda, Md. (1991))-   SEQ ID NO:39, 40, 41 indicates amino acid numbering as indicated in    SEQ ID NO:39, 40 and 41 of this document.-   See also FIG. 22 for comparison of numbering methods.

Numbering of CH3 mutations KABAT EU index G4 SEQ ID NO: 39, 40, 41 376Q355R Q235R 393 K370T K250T 436 F405A F285A 436 F405L F285L 440 R409AR289A 440 R409K R289K 440 R409L R289L 440 R409M R289M 440 R409T R289T450 E419Q E299Q 476 L445P L325P

IgG1-CD20 and IgG1-EGFr, IgG4-CD20 and IgG4-EGFr, or IgG4-CH3mutant-CD20and IgG4-CH3mutant-EGFr were mixed and incubated with 0.5 mM GSH asdescribed above. Bispecific activity was determined as described inExample 33.

FIG. 23 shows that bispecific anti-EGFr/CD20 antibodies were formed inmixtures of IgG4 antibodies as well as in mixtures of CH3 domain mutantsQ355R, E419Q, L445P and R409A. No bispecific activity was measured inmixtures of CH3 domain mutants R409K, R409M, R409L and K370T, indicatingthat these mutations stabilized dimerization of human IgG4 antibodies.CH3 domain mutant R409T, F405A and F405L partially stabilizeddimerization of human IgG4 antibodies.

SEQ ID NO:40: Amino Acid Sequence of the Wildtype C_(H) Region of HumanIgG4

1 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS WNSGALTSGV

51 HTFPAVLQSS GLYSLSSVVT VPSSSLGTKT YTCNVDHKPS NTKVDKRVES

101 KYGPPCPSCP APEFLGGPSV FLFPPKPKDT LMISRTPEVT CVVVDVSQED

151 PEVQFNWYVD GVEVHNAKTK PREEQFNSTY RVVSVLTVLH QDWLNGKEYK

201 CKVSNKGLPS SIEKTISKAK GQPREPQVYT LPPSQEEMTK NQVSLTCLVK

251 GFYPSDIAVE WESNGQPENN YKTTPPVLDS DGSFFLYSKL TVDKSRWQEG

1. A stabilized IgG4 antibody for use as a medicament, comprising aheavy chain and a light chain, wherein said heavy chain comprises ahuman IgG4 constant region having a substitution of the Arg residue atposition 409, the Phe residue at position 405 or the Lys residue atposition 370, wherein said antibody optionally comprises one or morefurther substitutions, deletions and/or insertions, with the provisothat if the antibody has a residue selected from the group consistingof: Lys, Ala, Thr, Met and Leu at the position corresponding to 409,then the antibody does not comprise a Cys-Pro-Pro-Cys sequence in thehinge region.
 2. The stabilized IgG4 antibody of claim 1, wherein saidheavy chain comprises a human IgG4 constant region having a residueselected from the group consisting of: Lys, Ala, Thr, Met and Leu at theposition corresponding to 409 and/or a residue selected from the groupconsisting of: Ala, Val, Gly, He and Leu at the position correspondingto 405, and wherein said antibody optionally comprises one or morefurther substitutions, deletions and/or insertions, but does notcomprise a Cys-Pro-Pro-Cys sequence in the hinge region.
 3. Thestabilized IgG4 antibody of claim 1, wherein said antibody comprises aLys, Ala, Thr, Met or Leu residue at the position corresponding to 409.4. The stabilized IgG4 antibody of claim 1, wherein said antibodycomprises a Lys, Thr, Met or Leu residue at the position correspondingto
 409. 5. The stabilized IgG4 antibody of claim 1, wherein saidantibody comprises a Lys, Met or Leu residue at the positioncorresponding to
 409. 6. The stabilized IgG4 antibody of claim 1,wherein the CH3 region of the antibody has been replaced by the CH3region of human IgG1, of human IgG2 or of human IgG3.
 7. The stabilizedIgG4 antibody of claim 1, wherein said antibody at the positioncorresponding to 405 has a residue which has a lower mass than Phe. 8.The stabilized IgG4 antibody of claim 1, wherein said antibody comprisesan Ala or Leu residue at the position corresponding to
 405. 9. Thestabilized IgG4 antibody of claim 1, wherein said antibody comprises aThr residue at the position corresponding to
 370. 10. The stabilizedIgG4 antibody of claim 1, wherein said antibody does not comprise asubstitution of the Leu residue at the position corresponding to 235 bya Glu.
 11. The stabilized IgG4 antibody of claim 1, wherein saidantibody does comprise a substitution of the Leu residue at the positioncorresponding to 235 by a Glu.
 12. The stabilized IgG4 antibody of claim1, wherein said antibody comprises one or more of the followingsubstitutions: an Ala at position 234, an Ala at position 236, an Ala atposition 237, an Ala at position 297, an Ala or Val at position 318, anAla at position 320, an Ala or Gln at position
 322. 13. The stabilizedIgG4 antibody of claim 1, wherein said antibody does not comprise aCys-Pro-Pro-Cys sequence in the hinge region.
 14. The stabilized IgG4antibody of claim 1, wherein said antibody comprises a CXPC or CPXCsequence in the hinge region, wherein X can be any amino acid except forproline.
 15. The stabilized IgG4 antibody of claim 1, wherein saidantibody does not comprise an extended IgG3-like hinge region.
 16. Thestabilized IgG4 antibody of claim 1, wherein said antibody comprises aCPSC sequence in the hinge region.
 17. The stabilized IgG4 antibody ofclaim 1, wherein said antibody comprises a constant heavy chain regioncomprising an amino acid sequence selected from the group consisting of:SEQ ID NO:39, 40 and 41 or a variant of said amino acid sequence havingless than 25 substitutions, deletions and/or insertions compared to saidamino acid sequence.
 18. The stabilized IgG4 antibody of claim 1,wherein said antibody is less efficient in mediating CDC and/or ADCCthan a corresponding IgG1 or IgG3 antibody having the same variableregions.
 19. The stabilized IgG4 antibody of claim 1, wherein saidantibody comprises a constant heavy chain region comprising the aminoacid sequence set forth in SEQ ID NO:40.
 20. The stabilized IgG4antibody of claim 1, wherein said antibody is selected from the groupconsisting of: a human antibody, a humanized antibody and a chimericantibody.
 21. The stabilized IgG4 antibody of claim 1, wherein saidantibody comprises a human kappa light chain.
 22. The stabilized IgG4antibody of claim 1, wherein said antibody comprises a human lambdalight chain.
 23. The stabilized IgG4 antibody of claim 1, wherein saidantibody is a bivalent antibody.
 24. The stabilized IgG4 antibody ofclaim 1, wherein said antibody is a full-length antibody.
 25. Thestabilized IgG4 antibody of claim 1, wherein said antibody is linked toa compound selected from the group consisting of: a cytotoxic agent; aradioisotope; a prodrug or drug, such as a taxane; a cytokine; and achemokine.
 26. The stabilized IgG4 antibody of claim 1, wherein theantibody binds an antigen selected from the group consisting of:erythropoietin, beta-amyloid, thrombopoietin, interferon-alpha (2a and2b), interferon-beta (1b), interferon-gamma, TNFR I (CD120a), TNFR II(CD120b), IL-IR type 1 (CD121a), IL-IR type 2 (CD121b), IL-2, IL2R(CD25), IL-2R-beta (CD123), IL-3, IL-4, IL-3R (CD123), IL-4R (CD124),IL-5R (CD125), IL-6R-alpha (CD126), -beta (CD130), IL-8, IL-10, IL-Il,IL-15, IL-15BP, IL-15R, IL-20, IL-21, TCR variable chain, RANK, RANK-L,CTLA4, CXCR4R, CCR5R, TGF-beta1, -beta2,-beta3, G-CSF, GM-CSF, MIF-R(CD74), M-CSF-R (CD115), GM-CSFR (CD116), soluble FcRI, sFcRII, sFcRIII,FcRn, Factor VII, Factor VIII, Factor IX, VEGF, VEGFxxxb, alpha-4integrin, Cd 11a, CD18, CD20, CD38, CD25, CD74, FcalphaRI, FcepsilonRI,acetyl choline receptor, fas, fasL, TRAIL, hepatitis virus, hepatitis Cvirus, envelope E2 of hepatitis C virus, tissue factor, a complex oftissue factor and Factor VII, EGFr, CD4, CD28, VLA-I, 2, 3, or 4, LFA-I,MAC-I, 1-selectin, PSGL-I, ICAM-I, P-selectin, periostin, CD33 (Siglec3), Siglec 8, TNF, CCL1, CCL2, CCL3, CCL4, CCL5, CCLU, CCL13, CCL17,CCL18, CCL20, CCL22, CCL26, CCL27, CX3CL1, LIGHT, EGF, VEGF, TGFalpha,HGF, PDGF, NGF, complement or a related components such as: CIq, C4, C2,C3, C5, C6, C7, C8, C9, MBL, factor B, a Matrix Metallo Protease such asany of MMP1 to MMP28, CD32b, CD200, CD200R, Killer Immunoglobulin-LikeReceptors (KIRs), NKG2D and related molecules, leukocyte-associatedimmunoglobulin-like receptors (LAIRs), Iv49, PD-L2, CD26, BST-2, ML-IAP(melanoma inhibitor of apoptosis protein), cathepsin D, CD40, CD40R,CD86, a B cell receptor, CD79, PD-I and a T cell receptor.
 27. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds analpha-4 integrin and is for use in the treatment of inflammatory andautoimmune diseases, such as rheumatoid arthritis, multiple sclerosis,inflammatory bowel disease, asthma and sepsis.
 28. The stabilized IgG4antibody of claim 26, wherein the antibody binds VLA-I, 2, 3, or 4 andis for use in the treatment of inflammatory and autoimmune diseases,such as rheumatoid arthritis, multiple sclerosis, inflammatory boweldisease, asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis,COPD and sepsis.
 29. The stabilized IgG4 antibody of claim 26, whereinthe antibody binds a molecule selected from the group consisting of:LFA-I, MAC-I, 1-selectin and PSGL-I and is for use in the treatment ofinflammatory and autoimmune diseases, such as rheumatoid arthritis,multiple sclerosis, inflammatory bowel disease, asthma, type-1 diabetes,SLE, psoriasis, atopic dermatitis, and COPD.
 30. The stabilized IgG4antibody of claim 26, wherein the antibody binds a molecule selectedfrom the group consisting of: LFA-I, MAC-I, 1-selectin and PSGL-I and isfor use in the treatment of a disease selected from the group consistingof ischemia-reperfusion injury, cystic fibrosis, osteomyelitis,glomerulonepritis, gout and sepsis.
 31. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds CD18 and is for use in thetreatment of inflammatory and autoimmune diseases, such as rheumatoidarthritis, multiple sclerosis, inflammatory bowel disease, asthma,type-1 diabetes, SLE, psoriasis, atopic dermatitis and COPD.
 32. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds Cd 11aand is for use in the treatment of inflammatory and autoimmune diseases,such as rheumatoid arthritis, multiple sclerosis, inflammatory boweldisease, asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis andCOPD.
 33. The stabilized IgG4 antibody of claim 26, wherein the antibodybinds ICAM-I and is for use in the treatment of inflammatory andautoimmune diseases, such as rheumatoid arthritis, multiple sclerosis,inflammatory bowel disease, asthma, type-1 diabetes, SLE, psoriasis,atopic dermatitis and COPD.
 34. The stabilized IgG4 antibody of claim26, wherein the antibody binds P-selectin and is for use in thetreatment of cardiovascular diseases, post-thrombotic vein wallfibrosis, ischemia reperfusion injury, inflammatory diseases or sepsis.35. The stabilized IgG4 antibody of claim 26, wherein the antibody bindsperiostin and is for use in the treatment of malignant diseases and/ormetastising diseases, such as ovary cancer, endometrial cancer, NSCLC,glioblastoma, brain-related tumors, breast cancer, OSCC, colon cancer,pancreatic cancer, HNSCC, kidney cancer, thymoma, lung cancer, skincancer, larynx cancer, liver cancer, parotid tumors, gastric cancer,esophagus cancer, prostate cancer, bladder cancer and cancer of thetestis.
 36. The stabilized IgG4 antibody of claim 26, wherein theantibody binds CD33 (Siglec 3), is optionally coupled to a toxin,cytotoxic or cytostatic drug, and is for use in the treatment of tumorsexpressing CD33 or acute myeloid leukemia.
 37. The stabilized IgG4antibody of claim 26, wherein the antibody binds Siglec 8 and is for usein the treatment of: asthma, inflammatory or autoimmune diseases, suchas rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease,asthma, type-1 diabetes, SLE, psoriasis, atopic dermatitis and COPD. 38.The stabilized IgG4 antibody of claim 26, wherein the antibody binds TNFand is for use in the treatment of: inflammatory and autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma, type-1 diabetes, SLE, psoriasis, atopicdermatitis, COPD and sepsis.
 39. The stabilized IgG4 antibody of claim26, wherein the antibody binds CCL1, CCL2, CCL3, CCL4, CCL5, CCLU,CCL13, CCL17, CCL18, CCL20, CCL22, CCL26, CCL27 or CX3CL1 and is for usein the treatment of: atopic dermatitis, inflammatory and autoimmunediseases, such as rheumatoid arthritis, multiple sclerosis, inflammatorybowel disease, asthma, type-1 diabetes, SLE, psoriasis, COPD and sepsis.40. The stabilized IgG4 antibody of claim 26, wherein the antibody bindsLIGHT and is for use in the treatment of a disease selected from thegroup consisting of: hepatitis, inflammatory bowel disease, GVHD andinflammation.
 41. The stabilized IgG4 antibody of claim 26, wherein theantibody binds EGF, VEGF, TGFalpha or HGF and is for use in thetreatment of: malignant diseases, such as solid cancers.
 42. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds PDGFand is for use in the treatment of: diseases in which abnormal cellproliferation cell migration and/or angiogenesis occurs, such asatherosclerosis, fibrosis, and malignant diseases.
 43. The stabilizedIgG4 antibody of claim 26, wherein the antibody binds NGF and is for usein the treatment of: neurological diseases, neurodegenerative diseases,such as Alzheimer's disease and Parkinson's disease, or cancer, such asprostate cancer.
 44. The stabilized IgG4 antibody of claim 26, whereinthe antibody binds complement or a related components such as: CIq, C4,C2, C3, C5, C6, C7, C8, C9, MBL, or factor B and is for use in: diseasesin which complement and related components play a detrimental role, suchas organ transplant rejection, multiple sclerosis, Guillain-Barresyndrome, hemolytic anemia, Paroxysmal Nocturnal Hemoglobinuria, stroke,heart attacks, burn injuries, age-related macular degeneration, asthma,lupus, arthritis, myasthenia gravis, anti-phospholipid syndrome, sepsisand ischemia reperfusion injury.
 45. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds a Matrix Metallo Protease such asany of MMP1 to MMP28 and is for use in the treatment of: inflammatoryand autoimmune diseases, cancer, including metastatic cancer; arthritis,inflammation, cardiovascular diseases, cerebrovascular diseases such asstroke or cerebral aneurysms, pulmonary diseases such as asthma, oculardiseases such as corneal wound healing or degenerative genetic eyediseases, gastrointestinal diseases such as inflammatory bowel diseaseor ulcers, oral diseases such as dental caries, oral cancer orperiodontitis, ischemia repoerfusion injury or sepsis.
 46. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds CD32band is for use in enhancement of T-cell responses to tumor antigens andADCC/phagocytosis by macrophages, in combination with anothertherapeutic antibody; vaccination, immunotherapy of B-cell lymphoma's,asthma or allergy.
 47. The stabilized IgG4 antibody of claim 26, whereinthe antibody binds CD200 or CD200R and is for use in the treatment of:asthma, rheumatoid arthritis, GVHD, other autoimmune diseases, orcancer, such as solid tumors or lymphomas.
 48. The stabilized IgG4antibody of claim 26, wherein the antibody binds KillerImmunoglobulin-Like Receptors (KIRs), NKG2D or related molecules,leukocyte-associated immunoglobulin-like receptors (LAIRs), or Iy49 andis for use in the treatment of: cancer, such as solid tumors orlymphomas; asthma, rheumatoid arthritis, GVHD or other autoimmunediseases.
 49. The stabilized IgG4 antibody of claim 26, wherein theantibody binds PD-L2 and is for use in the treatment of: cancer, asthma,or for use in vaccine enhancement.
 50. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds CD26 and is for use in thetreatment of: atherosclerosis, GVHD, or auto-immune diseases.
 51. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds BST-2and is for use in the treatment of: asthma, atherosclerosis, rheumatoidarthritis, psoriasis, Crohn's disease, ulcerative cholitis, atopicdermatitis, sepsis or inflammation.
 52. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds ML-IAP (melanoma inhibitor ofapoptosis protein) and is for use in the treatment of melanoma.
 53. Thestabilized IgG4 antibody of claim 26, wherein the antibody bindscathepsin D and is for use in the treatment of: malignant diseases suchas breast cancer, ovarian cancer, glioma, NSCLC, bladder cancer,endometrial cancer, liver cancer, sarcoma, gastric cancer, SCCHN,prostate cancer or colorectal cancer.
 54. The stabilized IgG4 antibodyof claim 26, wherein the antibody binds CD40 or CD40R and is for use inthe treatment of: cancer, in particular B-cell lymphomas, B-cell-relatedor -mediated diseases, autoimmune diseases such as psoriatic arthritis,rheumatoid arthritis, multiple sclerosis, psoriasis, Crohn's disease orulcerative cholitis.
 55. The stabilized IgG4 antibody of claim 26,wherein the antibody binds CD86 and is for use in conjunction with organtransplantation.
 56. The stabilized IgG4 antibody of claim 26, whereinthe antibody binds a B cell receptor and is for use in the treatment of:B-cell-related or -mediated diseases, such as B cell lymphoma's,leukemia, autoimmune diseases, inflammation or allergy.
 57. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds CD79and is for use in the treatment of B-cell-related or -mediated diseases,such as B-cell lymphomas, leukemia, autoimmune diseases, inflammation orallergy.
 58. The stabilized IgG4 antibody of claim 26, wherein theantibody binds a T cell receptor and is for use in the treatment ofT-cell-related or -mediated diseases, such as T-cell lymphomas,leukemia, autoimmune diseases, inflammation or allergy.
 59. Thestabilized IgG4 antibody of claim 26, wherein the antibody bindsFcalphaRI and is for use in the treatment of a disease or disorderselected from: allergic asthma or other allergic diseases such asallergic rhinitis, seasonal/perennial allergies, hay fever, nasalallergies, atopic dermatitis, eczema, hives, urticaria, contactallergies, allergic conjunctivitis, ocular allergies, food and drugallergies, latex allergies, or insect allergies, or IgA nephropathy,such as IgA pemphigus.
 60. The stabilized IgG4 antibody of claim 26,wherein the antibody binds CD25 and is for use in the treatment of adisease or disorder selected from the group consisting of: transplantrejection, graft-versus-host disease, inflammatory, immune or autoimmunediseases, inflammatory or hyperproliferative skin disorders, lymphoidneoplasms, malignancies, hematological disorders, skin disorders,hepato-gastrointestinal disorders, cardiac disorders, vasculardisorders, renal disorders, pulmonary disorders, neurological disorders,connective tissue disorders, endocrinological disorders, viralinfections.
 61. The stabilized IgG4 antibody of claim 26, wherein theantibody binds IL-15 or the IL15 receptor and is for use in thetreatment of a disease or disorder selected from the group consistingof: arthritides, gout, connective disorders, neurological disorders,gastrointestinal disorders, hepatic disorders, allergic disorders,hematologic disorders, skin disorders, pulmonary disorders, malignantdisorders, endocrinological disorders, vascular disorders, infectiousdisorders, kidney disorders, cardiac disorders, circulatory disorders,metabolic disorders, bone, disorders and muscle disorders.
 62. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds IL-8and is for use in the treatment of a disease or disorder selected fromthe group consisting of: palmoplantar pustulosis (PPP), psoriasis, orother skin diseases, inflammatory, autoimmune and immune disorders,alcoholic hepatitis and acute pancreatitis, diseases involving IL-8mediated angiogenesis.
 63. The stabilized IgG4 antibody of claim 26,wherein the antibody binds CD20 and is for use in the treatment of adisease or disorder selected from the group consisting of: rheumatoidarthritis, (auto)immune and inflammatory disorders, non-Hodgkin'slymphoma, B-CLL, lymphoid neoplasms, malignancies and hematologicaldisorders, infectious diseases and connective disorders, neurologicaldisorders, gastrointestinal disorders, hepatic disorders, allergicdisorders, hematologic disorders, skin disorders, pulmonary disorders,malignant disorders, endocrinological disorders, vascular disorders,infectious disorders, kidney disorders, cardiac disorders, circulatorydisorders, metabolic disorders, bone and muscle disorders, and immunemediated cytopenia.
 64. The stabilized IgG4 antibody of claim 26,wherein the antibody binds CD38 and is for use in the treatment of adisease or disorder selected from the group consisting of: tumorigenicdisorders, immune disorders in which CD38 expressing B cells, plasmacells, monocytes and T cells are involved, acute respiratory distresssyndrome and choreoretinitis, rheumatoid arthritis, inflammatory, immuneand/or autoimmune disorders in which autoantibodies and/or excessive Band T lymphocyte activity are prominent, skin disorders, immune-mediatedcytopenias, connective tissue disorders, arthritides, hematologicdisorders, endocrinopathies, hepato-gastrointestinal disorders,nephropathies, neurological disorders, cardiac and pulmonary disorders,allergic disorders, ophthalmologic disorders, infectious diseases,gynecological-obstetrical disorders, male reproductive disorders,transplantation-derived disorders,
 65. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds EGFr and is for use in thetreatment of a disease or disorder selected from the group consistingof: cancers (over)expressing EGFr and other EGFr related diseases, suchas autoimmune diseases, psoriasis, inflammatory arthritis.
 66. Thestabilized IgG4 antibody of claim 26, wherein the antibody binds CD4 andis for use in the treatment of a disease or disorder selected from thegroup consisting of: rheumatoid arthritis, (auto)immune and inflammatorydisorders, cutaneous T cell lymphomas, non-cutaneous T cell lymphomas,lymphoid neoplasms, malignancies and hematological disorders, infectiousdiseases, and connective disorders, neurological disorders,gastrointestinal disorders, hepatic disorders, allergic disorders,hematologic disorders, skin disorders, pulmonary disorders, malignantdisorders, endocrinological disorders, vascular disorders, infectiousdisorders, kidney disorders, cardiac disorders, circulatory disorders,metabolic disorders, bone disorders, muscle disorders, immune mediatedcytopenia, and HIV infection/AIDS.
 67. The stabilized IgG4 antibody ofclaim 26, wherein the antibody binds CD28 and is for use in thetreatment of a disease or disorder selected from the group consistingof: an inflammatory disease, autoimmune disease and immune disorder. 68.The stabilized IgG4 antibody of claim 26, wherein the antibody bindstissue factor, or a complex of Factor VII and tissue factor and is foruse in the treatment of a disease or disorder selected from the groupconsisting of: vascular diseases, such as myocardial vascular disease,cerebral vascular disease, retinopathy and macular degeneration, andinflammatory disorders.
 69. The stabilized IgG4 antibody of claim 26,wherein the antibody binds PD-I and is for use in the treatment ofHIV-I/AIDS.
 70. An isolated stabilized IgG4 antibody, comprising a heavychain and a light chain, wherein said heavy chain comprises a human IgG4constant region having a substitution of the Arg residue at position409, the Phe residue at position 405 or the Lys residue at position 370,wherein said antibody optionally comprises one or more furthersubstitutions, deletions and/or insertions, with the proviso that if theantibody has a residue selected from the group consisting of: Lys, Ala,Thr, Met and Leu at the position corresponding to 409, then the antibodydoes not comprise a Cys-Pro-Pro-Cys sequence in the hinge region and theproviso that the antibody does not comprise both a Lys at position 409and a Leu at position
 309. 71. The stabilized IgG4 antibody of claim 70,wherein said heavy chain comprises a human IgG4 constant region having aresidue selected from the group consisting of: Lys, Ala, Thr, Met andLeu at the position corresponding to 409 and/or a residue selected fromthe group consisting of: Ala, VaI, GIy, He and Leu at the positioncorresponding to 405, and wherein said antibody optionally comprises oneor more further substitutions, deletions and/or insertions, but does notcomprise a Cys-Pro-Pro-Cys sequence in the hinge region.
 72. Apharmaceutical composition comprising a stabilized IgG4 antibody asdefined in claim
 1. 73. Use of a stabilized IgG4 antibody as defined inclaim 24 for the preparation of a medicament for the treatment of adisease or disorder as defined in said claim.
 74. A method for producinga stabilized IgG4 antibody of claim 1, said method comprising expressinga nucleic acid construct encoding said antibody in a host cell andoptionally purifying said antibody.
 75. The method of claim 74, whereinsaid stabilized IgG4 antibody does not comprise both a Lys at position409 and a Leu at position 309.